植物粪石性急性小肠梗阻的CT诊断

目的:探讨植物粪石性急性小肠梗阻(SBO)的CT表现和诊断价值。方法:回顾性分析经外科手术证实的12例植物粪石性急性SBO患者的临床资料和CT表现。结果:12例小肠植物粪石均为单发,其中3例同时伴有胃内粪石。小肠粪石大小3 cm×3.5 cm～4.2 cm×5 cm,在CT上均表现为一个边缘清楚的卵圆形或圆形含有气泡的斑点状软组织肿块,位于梗阻部位的管腔内,其中位于十二指肠1例,空肠4例,回肠7例。所有病例均显示粪石近段小肠扩张(管径>3 cm),远侧小肠突然萎陷。结论:小肠植物粪石具有特征性的CT表现,CT检查是诊断植物粪石性急性SBO的最佳方法。

CT diagnosis of acute small bowel obstruction due to phytobezoars

Objective： To discuss the CT findings of acute small bowel obstruction（SBO） due to phytobezoars and its diagnostic value. Methods.. CT and clinical data of 12 patients with surgically confirmed acute SBO due to phytobezoars were retrospectively analyzed. Results： Of the 12 patients with phytobezoar-induced SBO, nine patients were diagnosed as having single small bowel phytobezoar alone, three patients had single small bowel phytobezoar associated with a gastric bezoar. The sizes of phytobezoars ranged from 3 cm×3.5 cm-4.2 cm×5 cm. They were localized in the duodenum（ n =1）, jejunum（ n =4）, ileum（ n = 7）. On CT, the phytobezoars appeared as well-defined ovoid or round intraluminal masses with mottled gas pattern at the site of obstruction and caused dilatation of the proximal small bowel（〉3 cm in diameter） and abrupt collapse of the lumen beyond phytobezoars in all patients. Conclusion： The CT findings of small bowel phytobezoars are characteristic. The CT imaging is the optimal choice in making the diagnosis of phytobezoar associated with acute small bowel obstruction.