老年人常见结肠穿孔疾病的MSCT诊断及鉴别诊断

发布时间：2018-02-27 23:09

本文关键词： 结肠肠穿孔 MSCT 老年人结肠癌肠Crohn病憩室炎　出处：《临床放射学杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的探讨老年人结肠穿孔常见疾病的MSCT影像表现。方法回顾性分析38例老年人结肠穿孔的MSCT资料。结果结肠穿孔CT主要表现:腹盆腔及腹膜后游离气体、肠腔外局限性小气泡,黏膜线中断、腹盆腔积液、脓肿形成。38例中,结肠癌15例,CT表现为肠壁不规则增厚,肠腔狭窄,系膜条索影。结肠Crohn病11例,CT表现为不对称性、节段性肠壁增厚,分层样强化,肠系膜血管增粗,小淋巴结。结肠憩室炎5例,CT表现为结肠肠壁外囊袋状突出,内见小气泡、粪石影。外伤性1例,医源性4例,不明原因2例。结论老年人易发生结肠穿孔,病因多样,CT表现有一定的特异性,有助于尽早诊断穿孔、明确穿孔病因,为临床及时制定手术方案提供依据。
[Abstract]:Objective to investigate the MSCT imaging findings of common diseases of colon perforation in the elderly. Methods the MSCT data of 38 cases of colon perforation in the elderly were analyzed retrospectively. Results CT features of colon perforation were as follows: free gas in abdominal and pelvic cavity and retroperitoneal cavity, small bubbles in extraintestinal cavity. Among 38 cases of mucosal disruption, abdominal and pelvic effusion and abscess formation, 15 cases of colon cancer showed irregular thickening of intestinal wall, stricture of intestinal cavity and mesenteric stripe. 11 cases of Crohn's disease of colon showed asymmetry, segmental wall thickening and laminar enhancement. Mesenteric vessel thickening and small lymph nodes. Ct findings of 5 cases of colonic diverticulitis showed pouch protrusion of the outer wall of colon, small bubbles, faecal stone shadow, traumatic in 1 case, iatrogenic in 4 cases, unknown cause in 2 cases. Conclusion Colon perforation is easy to occur in the elderly. The CT findings of various etiological factors are specific, which is helpful to diagnose perforation as early as possible, to determine the etiology of perforation, and to provide basis for clinical operation plan in time.
【作者单位】：暨南大学附属第一医院影像中心;广东省佛山市南海区人民医院;
【分类号】：R656.9;R816.5

【参考文献】