Gagliardi M, Muglia P
Servizio di Radiologia II, Azienda Ospedaliera Villa Sofia, CTO, Palermo.
Radiol Med. 1996 Oct;92(4):405-8.
Acute gastroduodenal ulcer in the adult is usually diagnosed with endoscopy and conventional radiology, but some literature papers indicate the better yield of ultrasonography (US) relative to other conventional exams. Our series consisted of 12 patients with gastroduodenal ulcer diagnosed with US on the first visit; 5 ulcers were in the gastric antrum and 7 in the duodenal bulb. We diagnosed a characteristic "target" US pattern caused by hypoechoic thickening of the walls surrounding the irregular hyperechoic lumen in 10 patients. Another US pattern was also detected in one patient with erosion of the first layers of the gastric antrum wall, with preserved deep layers, and in another patient with duodenal bulb ulceration and associated intestinal perforation with liquid pooling under the liver. All diagnoses were confirmed with endoscopy and conventional radiology. We aimed at investigating US adequacy as the diagnostic method of choice in patients with acute abdominal symptoms and suspected abdominal ulcer where US can show the characteristic signs of disease and help refer the patient to other more specific diagnostic exams as soon as possible.
成人急性胃十二指肠溃疡通常通过内镜检查和传统放射学诊断,但一些文献表明,相对于其他传统检查,超声检查(US)的诊断率更高。我们的病例系列包括12例首次就诊时经超声诊断为胃十二指肠溃疡的患者;5例溃疡位于胃窦,7例位于十二指肠球部。我们在10例患者中诊断出一种特征性的超声“靶征”,表现为不规则高回声管腔周围壁的低回声增厚。在另1例胃窦壁浅层糜烂但深层保留的患者以及另1例十二指肠球部溃疡合并肠穿孔且肝下有液体聚集的患者中也检测到了另一种超声表现。所有诊断均经内镜检查和传统放射学证实。我们旨在研究超声检查作为急性腹痛症状和疑似腹部溃疡患者首选诊断方法的适用性,超声检查能够显示疾病的特征性体征,并有助于尽快将患者转诊至其他更具特异性的诊断检查。