北京协和医院：《放射诊断学》课程教学资源（PPT课件）空腔脏器常见疾病

空腔脏器常见疾病 北京协和医院放射科薛华丹

空腔脏器常见疾病 北京协和医院放射科 薛华丹

急腹症 ■检查方法及应用范围： -1、腹部平片：主要应于胃肠道穿孔性或梗阻性急腹症。 一2、钡灌肠造影：应用于肠套叠、扭转等梗阻性急腹症 的诊治。 -3、CT检查：可应用于所有急腹症检查，价值较高。 一4、超声检查：主要应用于实质性脏器外伤、腹腔积液、 局限性脓肿、结石与梗阻、肠套叠及急性炎症的检查

一 急腹症 检查方法及应用范围： – 1、腹部平片：主要应于胃肠道穿孔性或梗阻性急腹症。 – 2、钡灌肠造影：应用于肠套叠、扭转等梗阻性急腹症 的诊治。 – 3、CT检查：可应用于所有急腹症检查，价值较高。 – 4、超声检查：主要应用于实质性脏器外伤、腹腔积液、 局限性脓肿、结石与梗阻、肠套叠及急性炎症的检查

Possible causes of intestinal obstuction ■Congenital Inflammatory Lesion (extrinsic and intrinsic bowel) Trauma

Possible causes of intestinal obstuction Congenital Inflammatory Lesion (extrinsic and intrinsic bowel) Trauma

Classification Gastric outlet obstruction: only one/two air-fluid levels Homogeneous mass displacing transverse colon Duodenal obstruction: double-bubble sign; Frequently normal due to absence of gas from vomiting

Classification Gastric outlet obstruction: – only one/two air-fluid levels – Homogeneous mass displacing transverse colon Duodenal obstruction: – double-bubble sign; – Frequently normal due to absence of gas from vomiting

Classification Jejunal and ileal obstruction: Candy cane:>3 loops+>3cm gas-fluid levels+>3~5 hours onset Disparity in size between obstructed and normal loops Little/no gas stool in colon with complete mechanical obstruction after 12-24 hours Stepladder appearance;string-of-bead; Cave:fluid-distended loops may lead one to overlook obstruction!!!

Classification Jejunal and ileal obstruction: – Candy cane: >3 loops+>3cm gas-fluid levels+>3~5 hours onset – Disparity in size between obstructed and normal loops – Little/no gas + stool in colon with complete mechanical obstruction after 12-24 hours – Stepladder appearance; string-of-bead; Cave: fluid-distended loops may lead one to overlook obstruction!!!

Classification Colonic obstruction Dilated colon only Dilated small bowel (incompetent ileo-cecal valve) Gas-fluid levels distal to hepatic flexure (fluid is normal in cecum and ascending colon) Cecum most dilated portion (>10cm will be critical)

Classification Colonic obstruction – Dilated colon only – Dilated small bowel (incompetent ileo-cecal valve) – Gas-fluid levels distal to hepatic flexure (fluid is normal in cecum and ascending colon) – Cecum most dilated portion (>10cm will be critical)

■大肠扭转

肠扭转 大肠扭转