创伤性胰腺炎的CT征象

发布时间：2018-03-01 09:42

本文关键词： 胰腺炎创伤和损伤体层摄影术螺旋计算机　出处：《中国医学影像学杂志》2015年10期 　论文类型：期刊论文

【摘要】：目的创伤性胰腺炎易误诊且死亡率高,本文总结创伤性胰腺炎患者的临床表现和CT征象,以提高对本病的认识。资料与方法回顾性分析经手术或治疗后复查证实为创伤性胰腺炎的25例患者的临床资料和CT图像,根据胰腺实质损伤的深度分为浅表伤(创伤小于胰腺厚度的50%)和深部伤(创伤大于胰腺厚度的50%)。分析两种胰腺损伤类型临床和CT表现及其他脏器伴发损伤情况。结果胰腺浅表伤8例,深部伤17例,9例伴其他部位损伤。深部伤患者的临床表现为钝性中上腹疼、痛漫腹痛、恶心、呕吐,且重于浅表伤患者,动态观察两种损伤类型血清淀粉酶均有不同程度升高。7例延期手术者均出现胰腺假性囊肿、胰液外漏及腹膜炎等相关并发症。8例胰腺表浅伤患者中CT平扫首诊漏诊3例;17例胰腺深部伤中,次全断裂伤12例,完全断裂伤5例,CT平扫首诊漏诊1例。创伤性胰腺炎的CT直接征象为胰腺局限性异常密度区或胰实质连续性中断。结论创伤性胰腺炎的临床表现复杂,CT直接征象为胰腺实质密度不均匀或连续性中断,创伤深度与主胰管损伤密切相关,间接征象需注意胰周渗出及伴发其他脏器损伤。
[Abstract]:Objective to summarize the clinical manifestations and CT findings of traumatic pancreatitis, which is prone to misdiagnosis and has a high mortality rate. Methods the clinical data and CT images of 25 patients with traumatic pancreatitis confirmed by surgery or treatment were retrospectively analyzed. According to the depth of pancreatic parenchymal injury, there were superficial trauma (less than 50% of pancreatic thickness) and deep injury (trauma greater than 50% of pancreatic thickness). The clinical and CT manifestations of the two types of pancreatic injury and other viscera associated injuries were analyzed. Results there were 8 cases of superficial pancreatic injury. The clinical manifestations of the patients with deep injury were blunt upper abdominal pain, diffuse abdominal pain, nausea and vomiting, and were more serious than those of superficial injury. The pancreatic pseudocyst was observed dynamically in 7 patients with delayed operation and 7 patients with elevated serum amylase in both types of injury. Among the 8 cases of pancreatic effusion and peritonitis and other related complications, the first CT scan missed diagnosis in 3 cases and 17 cases of deep pancreatic injury, 12 cases of subtotal rupture injury. In 5 cases of complete rupture injury, 1 case was misdiagnosed by plain CT scan. The direct CT signs of traumatic pancreatitis were local abnormal density area of pancreas or interrupted continuity of pancreatic parenchyma. Conclusion the clinical manifestations of traumatic pancreatitis are complicated CT direct signs. For pancreatic parenchyma density inhomogeneity or continuity interruption, The depth of trauma is closely related to the injury of the main pancreatic duct. Indirect signs should pay attention to peripancreatic exudation and other organ injuries.
【作者单位】：贵州医科大学附属医院肝胆外科;
【分类号】：R657.51;R816.5

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