摘要
目的探讨乙状结肠癌和乙状结肠扭转引起的肠梗阻的CT表现特征。方法34例腹部CT检查并手术病理证实为乙状结肠癌和乙状结肠扭转引起的肠梗阻病例,其中男25例,女9例,年龄52～78岁,平均67.1岁;临床表现包括腹痛、腹胀、呕吐、肛门停止排便及排气;体检发现腹部胀痛,有压痛、反跳痛及肠型,听诊肠鸣音亢进等。就以下CT表现进行分析:(1)梗阻部位;(2)梗阻近、远侧肠管;(3)合并症的CT征象。结果乙状结肠癌引起的梗阻24例,显示一般肠梗阻特点,2例出现盲袢综合征;梗阻部位均见肠腔狭窄及肠壁增厚;2例见淋巴转移;3例见肝转移。乙状结肠扭转10例,结肠均扩张、积气及积液,显著者8例;8例见“鸟嘴征”,4例见“漩涡征”。结论CT检查对诊断梗阻的原因及程度可提供更有价值的资料。
Purpose To explore the CT features of sigmoid obstruction caused by sigmoid cancer and sigmoid volvulus, Methods Thirtyfour cases of intestinal obstruction secondary to sigmoid cancer and sigmoid volvulus surgico-pathologically were retrospectively reviewed （Male：25 cases,Female：9 cases,Age：52-78 years old）. Before surgery,abdominal CT was performed in all patients. The CT findings including the obstruction site, the manifestations of the intestinal loop,and the complication,were retrospectively analyzed. Results Twenty-four cases of simple obstruction caused by sigmoid cancer showed typical signs such as dilatation,hydrocele of colon,with blind loop syndrome seen（in 2 cases）. Intestinal stenosis and bowel wall thickening were detected at the site of obstruction in all 24 cases. There were lymph node metastasis （n=2） and hepatic metastasis （n=3）. Sigmoid volvulus showed dilatation and hydrocele in 10 cases with beaking-sign （in 8 cases） and whirling-sign（in 4 cases）. Conclusion Abdominal CT can provide valuable data for judging the causes and degree of sigmoid obstruction.
出处
《上海医学影像》
2007年第2期159-161,共3页
Shanghai Medical Imaging
