繼發性化膿性腹膜炎CT特征表現及其解剖、病理基礎_《中國普外基礎與臨床雜志》

作者：

盧春燕閔鵬秋 , 劉榮波 , 伍兵 , 朱捷 , 董鵬 , 姚晉

四川大學華西醫院放射科（成都610041）;;
通訊作者: 閔鵬秋;

關鍵詞：

化膿性腹膜炎體層攝影術 X線計算機

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目的探討繼發性化膿性腹膜炎（secondary pyogenic peritonitis, SPP）的CT表現、顯示率及其解剖、病理基礎。
方法回顧性分析24例SPP的CT表現特征,著重觀察SPP在螺旋CT掃描中的基本CT表現和導致SPP的原發病灶及并發癥的CT表現以及它們的顯示率，并探討其解剖、病理基礎。
結果24例SPP的主要CT表現如下：腹膜增厚16例(66.7%)，其中光滑規則增厚14例，不規則增厚2例；腹腔積液15例(62.5%)；腹腔游離氣體9例(37.5%)；大網膜和小腸系膜水腫、增厚分別為8例(33.3%)、5例(20.8%)；腸壁水腫、增厚5例(20.8%)；腸曲間相互粘連6例(25.0%)。導致SPP的原發病灶及并發癥的CT表現：不同程度地顯示出導致SPP原發病灶征象13例(54.2%)，合并腹膜后間隙炎癥13例(54.2%)，胸部改變13例(54.2%)，以及腹、盆腔膿腫6例(25.0%)。
結論SPP的CT主要表現包括壁腹膜增厚，腹腔積液、積氣，大網膜和小腸系膜水腫、增厚等；次要表現包括腸壁水腫、增厚，腸曲間相互粘連等。應用CT掃描診斷SPP，可顯示較豐富的CT征象以協助診斷。

引用本文： 盧春燕閔鵬秋,劉榮波,伍兵,朱捷,董鵬,姚晉. 繼發性化膿性腹膜炎CT特征表現及其解剖、病理基礎. 中國普外基礎與臨床雜志, 2006, 13(1): 116-119下轉124. doi: 復制

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1. Mayers MA. Dynamic radiology of the abdomen: normal and pathologic anatomy [M]. 5th ed. New York： SpringerVerlag, 2000∶61-67.
2. Min PQ, Yang ZG, Lei QF, et al. Peritoneal reflections of left perihepatic region: radiologicanatomic study [Ｊ]. Radiology, 1992; 182(2)∶553.
3. Molmenti EP, Balfe DM, Kanterman RY, et al. Anatomy of the retroperitoneum: observations of the distribution of pathologic fluid collections [Ｊ]. Radiology, 1996; 200(1)∶95.
4. Thornton FJ, Kandiah SS, Monkhouse WS, et al. Helical CT evaluation of the perirenal space and its boundaries: a cadaveric study [Ｊ]. Radiology, 2001; 218(3)∶659.
5. Rodriguez E, Pombo F. Peritoneal tuberculosis versus peritoneal carcinomatosis: distinction based on CT findings [Ｊ]. J Comput Assist Tomogr, 1996; 20(2)∶269.
6. Krumenacker JH, Panicek DM, Ginsberg MS, et al. CT in searching for abscess after abdominal or pelvic surgery in patie6nts with neoplasia: do abdomen and pelvis both need to be scanned? [Ｊ]. J Comput Assist Tomogr, 1997; 21(4)∶652.
7. McDowell RK, Dawson SL. Evaluation of the abdomen in sepsis of unknown origin [Ｊ]. Radiol Clin North Am, 1996; 34(1)∶177.
8. Gore RM, Miller FH, Pereles FS, et al. Helical CT in the evaluation of the acute abdomen [Ｊ]. AJR Am J Roentgenol, 2000; 174(4)∶901.
9. 薛雁山, 紀智, 劉秀梅. 結核性腹膜炎的CT表現 [Ｊ]. 中華放射學雜志, 2000； 34(5)∶349.
10. Ha HK, Jung JI, Lee MS, et al. CT differentiation of tuberculous peritonitis and peritoneal carcinomatosis [Ｊ]. AJR Am J Roentgenol, 1996; 167(3)∶743.
11. Jadvar H, Mindelzun RE, Olcott EW, et al. Still the great mimicker: abdominal tuberculosis [Ｊ]. AJR Am J Roentgenol, 1997; 168(6)∶1455.

《中國普外基礎與臨床雜志》

繼發性化膿性腹膜炎CT特征表現及其解剖、病理基礎

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《中國普外基礎與臨床雜志》

繼發性化膿性腹膜炎CT特征表現及其解剖、病理基礎

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Content

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