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多层螺旋 CT(MDCT)对梅克尔憩室所致小肠梗阻(SBO)的特征。

Multidetector-row computed tomography (MDCT) features of small bowel obstruction (SBO) caused by Meckel's diverticulum.

机构信息

Department of Radiology, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

Department of Radiology, College of Medicine, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, Republic of Korea.

出版信息

Diagn Interv Imaging. 2016 Feb;97(2):227-32. doi: 10.1016/j.diii.2015.09.006. Epub 2015 Oct 19.

Abstract

OBJECTIVES

To report the multidetector-row computed tomography (MDCT) findings of small bowel obstruction (SBO) caused by Meckel's diverticulum.

MATERIALS AND METHODS

Ten patients (9 men and 1 woman; age range, 2-44 years; median age, 21years) with surgical proven Meckel's diverticulum who presented SBO on the preoperative MDCT were included in the study.

RESULTS

On MDCT, all patients presented with SBO, either high-grade (n=6) or low-grade obstruction (n=4). Meckel's diverticulum was identified in five patients (n=5, 50%) on preoperative MDCT. In the five patients in whom a diverticulum was not seen on preoperative MDCT, MDCT showed a transition site on ileum with dilated proximal loops (n=3), pneumoperitoneum (n=1), jejuno-jejunal intussusception (n=1). Transition zone was located near midline in four patients (4/5, 80%).

CONCLUSION

The diagnosis of Meckel's diverticulum complicated SBO can be made with certainty when the diverticulum is visualized on preoperative MDCT. However, the preoperative diagnosis is difficult if the Meckel's diverticulum is not noted on the MDCT. When the obstructive processes are visualized in the lower abdomen or pelvis, particularly near the midline, one should keep in mind that SBO may be caused by Meckel's diverticulum without prior surgical history.

摘要

目的

报告由 Meckel 憩室引起的小肠梗阻 (SBO) 的多排螺旋 CT (MDCT) 表现。

材料和方法

本研究纳入了 10 例经手术证实的 Meckel 憩室患者,这些患者均在术前 MDCT 上表现为 SBO(9 名男性和 1 名女性;年龄范围 2-44 岁;中位年龄 21 岁)。

结果

在 MDCT 上,所有患者均表现为 SBO,其中高等级(n=6)或低等级梗阻(n=4)。术前 MDCT 发现 5 例 Meckel 憩室(n=5,50%)。在术前 MDCT 未发现憩室的 5 例患者中,MDCT 显示回肠的过渡区有扩张的近端肠袢(n=3)、气腹(n=1)、空肠-空肠套叠(n=1)。过渡区位于 4 例患者(4/5,80%)的中线附近。

结论

当术前 MDCT 能看到憩室时,可以明确诊断 Meckel 憩室并发 SBO。然而,如果 MDCT 上没有发现 Meckel 憩室,则术前诊断困难。当梗阻过程在腹部下部或骨盆中显现出来,特别是在中线附近时,应牢记即使没有外科手术史,SBO 也可能是由 Meckel 憩室引起的。

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