Billaud Y, Pilleul F, Valette P J
Service d'Imagerie Médicale, Hôpital d'Instruction des Armées Desgenettes, Lyon, France.
J Radiol. 2002 May;83(5):641-6.
To evaluate the correlation between computed tomography (CT) and surgery, for the diagnosis of bezoar in small bowel obstruction. To analyze the predisposing etiologic factors in this population.
We reviewed retrospectively between 1994 and 1999, 12 patients whose final diagnosis was small bowel obstruction with bezoar. All patients underwent helical CT scan before treatment. Eight patients were treated by surgery and 4 recovered with gastric aspiration.
Small bowel obstruction was diagnosed by CT which always demonstrated a transition zone with ovoid intraluminal mass outlined by the bowel wall. The mass consisted of a mixture of soft tissue and internal gas bubbles like feces, suggesting bezoar. Surgery confirmed small bowel obstruction and presence of bezoar. Predisposing factors were: partial gastrectomy (2/12), post surgical adhesions (7/12), Meckel diverticulum (1/12) and dietary factors.
We agree with the authors of the few prior CT reports and suggest that the characteristic CT appearance of mottled gas pattern is pathognomonic of bezoar with an excellent correlation in our population.
评估计算机断层扫描（CT）与手术在诊断小肠梗阻性胃石症中的相关性。分析该人群中的易感病因。
我们回顾性分析了1994年至1999年间最终诊断为小肠梗阻性胃石症的12例患者。所有患者在治疗前均接受了螺旋CT扫描。8例患者接受了手术治疗，4例通过胃抽吸治愈。
CT诊断为小肠梗阻，总是显示出一个过渡区，肠壁勾勒出腔内椭圆形肿块。肿块由软组织和类似粪便的内部气泡混合组成，提示为胃石症。手术证实为小肠梗阻并存在胃石症。易感因素包括：部分胃切除术（2/12）、术后粘连（7/12）、梅克尔憩室（1/12）和饮食因素。
我们认同少数先前CT报告的作者观点，并认为斑片状气体模式的特征性CT表现对胃石症具有诊断意义，在我们的研究人群中具有良好的相关性。
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