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目的探讨螺旋CT对胃、十二指肠穿孔的诊断价值。方法回顾性分析经手术病理证实的56例胃、十二指肠穿孔患者的临床资料、传统X线改变和CT征象。56例中男46例,女10例,年龄9～79岁,平均46.2岁;胃溃疡穿孔20例,胃癌穿孔5例,十二指肠球部溃疡穿孔25例,外伤性胃穿孔2例,外伤性十二指肠穿孔4例。全部病例术前均经常规X线透视、摄片与CT检查。结果在56例中,常规X线透视与摄片仅发现19例膈下游离气体,而在CT像上有40例可见腹腔内形态、位置、大小不一的游离气体影,23例伴腹膜腔积液现象,10例仅见网膜囊内包裹性改变。结论CT能发现常规X线透视及摄片无膈下游离积气时的胃、十二指肠穿孔,具有早期诊断价值。
Objective To investigate the diagnostic value of spiral CT in the diagnosis of gastric and duodenal perforation. Methods The clinical data, traditional X-ray findings and CT findings of 56 patients with gastric and duodenal perforation proved by surgery and pathology were retrospectively analyzed. 56 cases of male 46 cases, 10 females, aged 9 to 79 years, mean 46.2 years; 20 cases of gastric ulcer perforation, gastric perforation in 5 cases, duodenal ulcer perforation in 25 cases, traumatic gastric perforation in 2 cases, Traumatic duodenal perforation in 4 cases. All cases were routine preoperative X-ray, radiography and CT examination. Results Of the 56 cases, only 19 cases of subphrenic gas were found by conventional X-ray and radiography, while 40 cases of intra-abdominal shape, location and size of free gas were observed on CT images. 23 cases had peritoneal cavity Effusions, 10 cases only retinal capsule encapsulation changes. Conclusion CT can be found in conventional X-ray and radiographs without gas under the free gas when the stomach, duodenum perforation, with early diagnosis.