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十二指肠憩室炎的CT表现

CT findings in duodenal diverticulitis.

作者信息

Pearl Monica S, Hill Michael C, Zeman Robert K

机构信息

Department of Radiology, George Washington University Medical Center, 900 23rd St., NW, 1st Floor Radiology, Washington, DC 20037, USA.

出版信息

AJR Am J Roentgenol. 2006 Oct;187(4):W392-5. doi: 10.2214/AJR.06.0215.

Abstract

OBJECTIVE

Duodenal diverticulitis is a rare complication of duodenal diverticulosis. It is often clinically misdiagnosed because it has no pathognomonic signs or symptoms and its CT findings may mimic other intraabdominal processes. We describe two patients with duodenal diverticulitis who presented with abdominal pain, nausea, and leukocytosis. At the time of initial presentation, only one of the two patients was diagnosed correctly. In the first case, which was initially misdiagnosed as acute pancreatitis, the correct diagnosis was evident only after the disease process had become more quiescent and a follow-up CT scan using orally and i.v.-administered contrast agents was performed. In the second case, the coronal reformatted images confirmed the diagnosis suggested by the axial images.

CONCLUSION

Duodenal diverticulitis can be a difficult CT diagnosis to make; however, maintaining it in the differential diagnosis of duodenal and pancreatic inflammatory processes and masses as well as defining the anatomy with nonaxial imaging including coronal images may be helpful in confirming the diagnosis.

摘要

目的

十二指肠憩室炎是十二指肠憩室病的一种罕见并发症。由于它没有特征性的体征或症状,且其CT表现可能与其他腹腔内病变相似,故临床上常被误诊。我们描述了两名表现为腹痛、恶心和白细胞增多的十二指肠憩室炎患者。在初次就诊时,两名患者中只有一人被正确诊断。在第一例中,最初被误诊为急性胰腺炎,只有在病情趋于平稳并使用口服和静脉注射造影剂进行后续CT扫描后,正确诊断才得以明确。在第二例中,冠状位重组图像证实了轴位图像所提示的诊断。

结论

十二指肠憩室炎的CT诊断可能具有挑战性;然而,在十二指肠和胰腺炎症性病变及肿块的鉴别诊断中考虑到该病,并利用包括冠状位图像在内的非轴位成像来明确解剖结构,可能有助于确诊。

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