Chen C H, Yang C C, Yeh Y H
Division of Gastroenterology, Department of Internal Medicine, Changhua Show-Chwan Memorial Hospital, Taiwan 500, ROC.
Hepatogastroenterology. 2001 Jul-Aug;48(40):1082-4.
BACKGROUND/AIMS: The purpose of this study was to determine the value of upright chest radiography and ultrasonography in demonstrating free air of perforated peptic ulcers. METHOLOGY: Eighty-four patients with perforated peptic ulcers receiving both upright chest radiography and ultrasonography before laparotomy. The sensitivity of each modality in demonstrating free air was correlated.
Among the 84 patients receiving both examinations, free air was demonstrated in only 39 (46%) upright chest radiographs and 46 (55%) ultrasonographs, the direct sign could be demonstrated in 57 (68%) patients by combined radiography and ultrasonography. Besides, the indirect sign of ascites could be demonstrated in 26 (31%) ultrasonographs.
Ultrasonography is more sensitive than upright chest radiography to demonstrate free air of perforated peptic ulcers, and it should be considered in those patients of suspected perforated peptic ulcers with negative upright chest radiography. Combined methods of upright chest radiography and ultrasonography can increase the overall sensitivity in demonstrating free air.
背景/目的：本研究旨在确定立位胸部X线摄影及超声检查在显示消化性溃疡穿孔游离气体方面的价值。方法：84例消化性溃疡穿孔患者在剖腹手术前行立位胸部X线摄影及超声检查。比较两种检查方法显示游离气体的敏感性。结果：84例患者均接受了两种检查，立位胸部X线片仅39例（46%）显示游离气体，超声检查有46例（55%）显示游离气体，联合X线摄影及超声检查57例（68%）患者可显示直接征象。此外，26例（31%）超声检查可显示腹水间接征象。结论：超声检查显示消化性溃疡穿孔游离气体比立位胸部X线摄影更敏感，对于立位胸部X线摄影阴性的疑似消化性溃疡穿孔患者应考虑行超声检查。立位胸部X线摄影与超声检查联合应用可提高显示游离气体的总体敏感性。
