老年十二指肠憩室合并并发症患者42例临床分析

发布时间：2018-11-12 14:23

【摘要】：目的分析老年十二指肠憩室合并并发症患者的临床特征,提高该病的诊断水平。方法选取42例老年十二指肠憩室出现并发症患者,分析其临床表现、上消化道造影及腹部CT影像学特征。结果憩室并发胆胰系统疾病34例中25例有黄疸,16例有发热,28例有腹痛。上消化道造影共检出憩室63个,单发32例(76.2%),10例(23.8%)为两个或两个以上。憩室继发炎症8例,表现为憩室轮廓不规则,黏膜皱襞增粗或消失。腹部CT表现为憩室内食物残渣存留,憩室壁增厚、边缘模糊,周边脂肪间隙密度增高,与周边脏器分界不清。34例合并胆胰疾病患者中,胆系结石28例,表现为胆囊、肝内外胆管高、低或混杂密度结石;胆管炎症8例,表现为胆管壁增厚毛糙;合并胰腺炎4例,表现为胰腺边缘毛糙,周围脂肪间隙密度增高。结论老年十二指肠憩室患者出现并发症时常表现为黄疸、腹痛、发热等,上消化道造影、腹部CT等影像学检查有助于该病的诊断。
[Abstract]:Objective to analyze the clinical features of elderly patients with duodenal diverticulum complicated with complications and to improve the diagnostic level of the disease. Methods 42 elderly patients with complications of duodenal diverticulum were selected and their clinical manifestations, upper gastrointestinal angiography and abdominal CT imaging features were analyzed. Results in 34 cases of diverticulum complicated with cholangiopancreatic diseases, jaundice occurred in 25 cases, fever in 16 cases and abdominal pain in 28 cases. Diverticulum was detected in 63 cases by upper gastrointestinal angiography, 32 cases (76.2%) were single, and 10 cases (23.8%) were two or more than two. Secondary inflammation of diverticulum was found in 8 cases with irregular outline of diverticulum and thickening or disappearance of mucosal fold. The abdominal CT showed that the food residue in the diverticulum was preserved, the wall of the diverticulum was thickened, the margin of the diverticulum was blurred, the density of the peripheral fat space was increased, and the boundary of the peripheral viscera was not clear. Among the 34 patients with cholangiopancreatic disease, 28 patients had cholecystolithiasis. High, low or mixed density stones of intrahepatic and extrahepatic bile ducts; Cholangitis was seen in 8 cases with thickening and roughness of the bile duct wall, and with pancreatitis in 4 cases, with coarse margin of pancreas and increased density of fat space around the pancreas. Conclusion the complications of the elderly patients with duodenal diverticulum are often jaundice, abdominal pain, fever, upper gastrointestinal angiography, abdominal CT and other imaging examination are helpful for the diagnosis of the disease.
【作者单位】：山东省交通医院;
【分类号】：R574.51

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