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计算机断层扫描在肠石引起的小肠梗阻中的作用:病例系列。

The role of computed tomography in enterolith causing small bowel obstruction: A case series.

机构信息

Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.

出版信息

Medicine (Baltimore). 2023 Sep 8;102(36):e35041. doi: 10.1097/MD.0000000000035041.

Abstract

Intestinal obstruction caused by enteroliths is an uncommon medical condition. Timely detection of the presence of enteroliths and identification of their origin can guide clinical treatment. This study aimed to present the Computed Tomography (CT) features of enterolithic ileus confirmed by surgery in 7 patients. Seven patients with surgically confirmed enterolithic ileus who were admitted to our hospital between December 2013 and December 2022 were continuously enrolled, and an abdominopelvic CT examination was performed before surgery. The imaging characteristics were then analyzed. In the transition zone of all patients with intestinal obstruction, the sharply defined intraluminal masses were found. Three of them had gallstones and 4 had primary enteroliths. All 5 enteroliths in the 4 patients with primary enteroliths were in the proximal small intestine and were low-density with gas. Additionally, 3 gallstones were present in the distal small bowel, and calcifications were observed. Simultaneously, cholecystitis and secondary cholecystoduodenal fistula were observed in all 3 patients with gallstones. Compared to gallstones, primary enteroliths tend to be higher positioned, less dense, and accompanied by gas. CT examination is very important, as it allows accurate identification, location, diagnosis, and identification of complications of the different types of enteroliths to provide a basis for surgery.

摘要

肠石引起的肠梗阻是一种不常见的医学病症。及时发现肠石的存在及其来源可以指导临床治疗。本研究旨在介绍 7 例经手术证实的肠石性肠梗阻的 CT 特征。连续纳入 2013 年 12 月至 2022 年 12 月期间因肠石性肠梗阻在我院住院的 7 例患者,所有患者术前均行腹部 CT 检查。然后分析影像学特征。在所有肠梗阻患者的移行区均发现边界清晰的腔内肿块。其中 3 例有胆石症,4 例有原发性肠石。在 4 例原发性肠石患者中,5 个肠石均位于近端小肠,呈低密度并伴有气体。此外,3 个胆石位于回肠末端,可见钙化。同时,3 例胆石症患者均伴有胆囊炎和继发性胆石性十二指肠瘘。与胆石症相比,原发性肠石往往位置较高、密度较低,并伴有气体。CT 检查非常重要,因为它可以准确识别、定位、诊断不同类型肠石并识别并发症,为手术提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1813/10489302/8091e2dfe4ad/medi-102-e35041-g001.jpg

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