Chang Liisa, Chang Minna, Chang Hanna M, Chang Aina I, Chang Fuju
Department of General Surgery, St. George's Hospital NHS Trust, London, UK.
School of Cancer & Pharmaceutical Sciences, King's College London, London, UK.
Emerg Radiol. 2018 Apr;25(2):189-196. doi: 10.1007/s10140-017-1568-5. Epub 2017 Nov 16.
Gallstone ileus is a rare cause of bowel obstruction, which mainly affects the elderly population. The associated mortality is estimated to be up to 30%. The presentation of gallstone ileus is notoriously non-specific, and this often contributes to the delay in diagnosis. The diagnosis of gallstone ileus relies on a radiological approach, and herein we discuss the benefits and drawbacks of the use of different modalities of radiological imaging: plain abdominal films, computed tomography, magnetic resonance imaging, and ultrasound scanning. Based on our case experience and review of the literature, the authors conclude that although an effective first-line tool, plain abdominal films are not adequate for diagnosing gallstone ileus. In fact, the gold standard in an acutely unwell patient is computed tomography.
胆石性肠梗阻是肠梗阻的一种罕见病因,主要影响老年人群。据估计,其相关死亡率高达30%。胆石性肠梗阻的临床表现 notoriously 不具特异性,这常常导致诊断延迟。胆石性肠梗阻的诊断依赖于影像学方法,在此我们讨论使用不同影像学检查方式的利弊:腹部平片、计算机断层扫描、磁共振成像和超声扫描。基于我们的病例经验和文献回顾,作者得出结论,尽管腹部平片是一种有效的一线工具,但对于诊断胆石性肠梗阻并不充分。事实上,对于急性不适患者,金标准是计算机断层扫描。