宫内节育器异位致绞窄性肠梗阻并肠坏死1例

发布时间：2018-06-17 06:04

本文选题：宫内避孕器 + 异位　；参考：《中国医学影像技术》2017年06期

【摘要】：正患者女,46岁,绝经3年。患者25年前于顺产60天后放置宫内节育器,1天前无明显诱因突发腹痛,呈阵发性绞痛,腹胀明显,肛门停止排气、排便。查体:右下腹肌紧张,压痛及反跳痛阳性。腹部X线检查:小肠局部积气扩张并多发小气液平;盆腔内见环形致密影(图1A)。X线诊断:肠梗阻。腹部CT平扫:腹腔内可见游离于子宫外的环形节育器影,部分小肠及系膜穿过节育器,呈降落伞样改变,小肠壁明显水肿,周围脂肪间隙不清;腹腔及盆腔内见水样密度影(图1B、1C)。CT诊断:宫内节育器异位致绞窄性肠梗阻,腹腔积液。行剖腹探查、肠
[Abstract]:The patient was 46 years old and postmenopausal for 3 years. The patient had no obvious inducement for sudden abdominal pain, obvious abdominal distention, anus stopping exhaust and defecation 1 day before placement of IUD after 60 days of spontaneous delivery 25 years ago. Physical examination: right lower abdominal muscle tension, tenderness and rebound pain positive. Abdominal X-ray examination: small intestine local gas dilatation and multiple small gas level, pelvic ring dense shadow (fig. 1 A, X ray diagnosis: intestinal obstruction. Abdominal CT plain scan: the abdominal cavity can be seen free outside the uterus ring device shadow, part of the small intestine and Mesangium through the device, a parachute like changes, small bowel wall edema, the surrounding fat space is not clear; In abdominal cavity and pelvic cavity, water density shadow was seen (fig. 1). Ct diagnosis: ectopic strangulated intestinal obstruction with intrauterine device and hydroceliac effusion. To perform exploratory laparotomy.
【作者单位】：兰州大学第二医院放射科;
【分类号】：R713;R816.91

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