Lee Ching-Hsing
Chang Gung Memorial Hospital Department of Emergency Medicine, Keelung and Chang Gung University College of Medicine Taoyuan Taiwan.
J Acute Med. 2021 Mar 1;11(1):28-31. doi: 10.6705/j.jacme.202103_11(1).0005.
Hollow organ perforation is a serious and common abdominal emergency. The diagnosis depends on history taking, physical examination, and radiological fi ndings. We reported a hollow organ perforation patient with only indirect radiological signs of the heterogenous enhanced lesion between the stomach, duodenum, and liver over initial abdominal computed tomography. Pneumoperitoneum occurred in follow-up chest X-ray 5 hours after the emergency department visit. The reason for the delayed occurrence of pneumoperitoneum, direct/indirect radiological signs of hollow organ perforation, and ways to avoid this pitfall are discussed.
中空器官穿孔是一种严重且常见的腹部急症。诊断依赖于病史采集、体格检查及影像学检查结果。我们报告了一例中空器官穿孔患者，其最初的腹部计算机断层扫描仅显示胃、十二指肠和肝脏之间存在不均匀强化病变的间接影像学征象。在急诊科就诊5小时后的随访胸部X线检查中出现了气腹。本文讨论了气腹延迟出现的原因、中空器官穿孔的直接/间接影像学征象以及避免这一陷阱的方法。
