Hulnick D H, Megibow A J, Balthazar E J, Gordon R B, Surapenini R, Bosniak M A
Radiology. 1987 Sep;164(3):611-5. doi: 10.1148/radiology.164.3.3615859.
Results of clinical, contrast enema (CE), and computed tomographic (CT) examinations in 39 patients with perforated colorectal neoplasms were retrospectively reviewed. Twenty patients were toxemic at initial presentation, but in only four patients was the diagnosis of perforated colorectal neoplasm initially suspected clinically. CE study was performed in 22 patients and enabled the diagnosis of perforated neoplasm in 11 cases, neoplasm alone in eight, and neither neoplasm nor perforation in three. CT was performed in 38 patients and enabled the diagnosis of perforated neoplasm in 36; pericolic phlegmon but no mass lesion was evident in two. In 16 patients, CT also demonstrated metastatic disease. Because of its reliability in establishing the diagnosis and staging the extent of the inflammatory and neoplastic disease, CT is indicated in cases of suspected or proved perforated colorectal neoplasm and in cases in which CE study findings are indeterminate or suggestive of perforated neoplasm.
对39例结直肠肿瘤穿孔患者的临床、钡剂灌肠（CE）及计算机断层扫描（CT）检查结果进行回顾性分析。20例患者初诊时有毒血症表现，但仅有4例患者初诊时临床怀疑为结直肠肿瘤穿孔。22例患者接受了CE检查，其中11例诊断为肿瘤穿孔，8例仅诊断为肿瘤，3例既未发现肿瘤也未发现穿孔。38例患者接受了CT检查，其中36例诊断为肿瘤穿孔；2例可见结肠周围蜂窝织炎但无肿块病变。16例患者CT检查还发现了转移病灶。由于CT在诊断及确定炎症和肿瘤性疾病范围方面具有可靠性，因此对于疑似或已证实的结直肠肿瘤穿孔病例以及CE检查结果不确定或提示肿瘤穿孔的病例，均建议进行CT检查。
