Chen C H, Huang H S, Yang C C, Yeh Y H
Division of Gastroenterology, Department of Internal Medicine, Changhua Show-Chwan Memorial Hospital, 542, Sec 1, Chung-Shang Rd, Changhua, Taiwan 500, ROC.
Hepatogastroenterology. 2001 Sep-Oct;48(41):1393-6.
BACKGROUND/AIMS: CT is not usually of priority to evaluate the pathology of the gastrointestinal tract, especially perforated peptic ulcer. However CT might be employed when the presentation is atypical. The study was to summarize the imaging features of perforated peptic ulcer in conventional CT and assess its ability of detecting perforated peptic ulcer.
The CTs of 14 consecutive patients with perforated peptic ulcer confirmed by operation were retrospectively reviewed. The CTs were obtained after intravenous contrast medium, but oral contrast medium was administered only in 5 patients. The CT findings were correlated with surgical findings.
Among these 14 patients, all the 14 patients (100%) had extraluminal air accumulation, 10 patients (71%) had abnormal fluid accumulation, and 5 (36%) patients had inflammatory changes in surrounding soft tissues. In addition, conventional CT could only demonstrate the site of perforation in 5 patients (36%) of them.
Conventional CT was valuable in the diagnosis of perforated peptic ulcer, and pneumoperitoneum was the most common feature. However the ability of conventional CT in localizing the site of perforation was poor.
背景/目的：CT通常并非评估胃肠道病变尤其是消化性溃疡穿孔的首要选择。然而，当临床表现不典型时，CT可能会被采用。本研究旨在总结传统CT下消化性溃疡穿孔的影像特征，并评估其检测消化性溃疡穿孔的能力。
回顾性分析14例经手术证实为消化性溃疡穿孔患者的CT图像。CT扫描均在静脉注射造影剂后进行，仅5例患者口服了造影剂。将CT表现与手术结果进行对比。
这14例患者中，14例（100%）均有腹腔积气，10例（71%）有异常积液，5例（36%）周围软组织有炎症改变。此外，传统CT仅能显示其中5例（36%）患者的穿孔部位。
传统CT对消化性溃疡穿孔的诊断有重要价值，气腹是最常见的表现。然而，传统CT定位穿孔部位的能力较差。
