Guitart Giménez J, Pagès Llinàs M, Domingo Ayllón M, Rimola Gibert J, Rodríguez Gómez S, Ayuso Colella C
Centre de Diagnòstic per la Imatge CDI, Hospital Clínic i Provincial de Barcelona, Barcelona, España.
Radiologia. 2013 Jul-Aug;55(4):340-5. doi: 10.1016/j.rx.2011.09.021. Epub 2012 Jan 9.
The aims of this review are to describe the main characteristics for the CT diagnosis of isolated caecal ischaemia (ICA) and give details of the differential diagnosis with other conditions with a similar clinical picture.
A retrospective study was conducted to review the CT findings of 4 patients diagnosed with ICA in our hospital. The parameters recorded to analyse their characteristics in the CT were: maximum thickness of the caecum wall, the appearance of the peri-caecum fat, presence of free fluid, signs of caecal or portal pneumatosis, the appearance of the caecal appendix, and general signs of the presence of vasculopathy.
In all cases it was recorded that there was a thickening of the walls of the blind loop with an abrupt transition between the caecal wall and the walls of the ascending colon wall. In all cases the caecal thickening had a characteristic image in the central area. Signs of caecal pneumatosis were observed in two cases. All of them had an appendix with normal characteristics.
The combination of caecal wall thickening with oedematous characteristics, with no changes in the appendix, ileum and colon, suggest the diagnosis of caecal ischaemia, particularly with the presence of pneumatosis.
本综述的目的是描述孤立性盲肠缺血（ICA）的CT诊断主要特征，并详细说明其与具有相似临床表现的其他病症的鉴别诊断。
进行一项回顾性研究，以回顾我院4例诊断为ICA患者的CT表现。记录用于分析其CT特征的参数包括：盲肠壁最大厚度、盲肠周围脂肪外观、游离液体的存在、盲肠或门静脉积气征象、盲肠阑尾外观以及血管病变存在的一般征象。
所有病例均记录到盲袢壁增厚，盲肠壁与升结肠壁之间有突然过渡。所有病例中盲肠增厚在中心区域有特征性影像。2例观察到盲肠积气征象。所有患者阑尾特征均正常。
盲肠壁增厚伴有水肿特征，而阑尾、回肠和结肠无变化，提示盲肠缺血的诊断，尤其是存在积气时。
