内镜超声诊断肠壁囊样积气症附13例临床资料分析

目的方法结果结论探讨肠壁囊样积气症（Pneumatosis cystoides intestinalis，PCI）的内镜超声特征及其临床诊断价值。对2001年1月至2009年1月应用内镜超声诊断的13例PCI患者资料进行回顾性分析。13例中，男性7例，女性6例，平均年龄45．4岁（23～72岁），10例伴有腹部疼痛、腹胀、腹泻、便血等症状，3例为无症状患者。病变位于乙状结肠、降结肠者7例，横结肠2例，升结肠4例，电子结肠镜发现突入肠腔的多发半球形隆起样病变，表面粘膜光滑；随即应用Fujinon超声微探头进行的内镜超声检查：在患病肠壁的粘膜下层呈现板状高回声结构伴后方声影。13例中，7例进行了高压氧治疗，3例进行了抗生素治疗，2例应用活检钳钳破囊壁，1例手术，9例取得良好的治疗效果。肠壁囊样积气症具有特定的内镜超声特征，内镜超声检查对PCI具有重要临床诊断价值。随着内镜超声的广泛应用，PCI的检出率将会大大提高。

Diagnostic Value of Endoscopic Ultrasonography in Pneumatosis Cystoides Intestinalis and Analysis of Clinical Data in 13 Cases

Objective： To investigate the diagnostic values of endoscopic ultrasonography EUS in pneumatosis cystoides intestinalis （PCI） and to summarize the ultrasonic characteristics. Methods： 13 patients, who were suspected as patients of PCI, underwent EUS. Ultrasound examination was performed with a Fujinon SP-701 ultrasonic catheter probe 12-20 MHz during the colonoscopy. Their clinical data and ultrasonic characteristics were retrospectively studied. Results： Among the 13 patients 7 male, 6 female, with age ranging from 23 to 72, average age 45.4, there were 10 patients with symptoms of middle and inferior abdominal pain, abdominal distention, diarrhea or bloody stools and 3 patients with symptomless. When colonoscopy disclosed Multiple hemispheric lesions with a smooth surface protruding into the lumen of the colon, the patients further underwent EUS. The lesions appeared as multiple hyperechogenic regions with distal acoustic shadowing on EUS which was characteristic EUS imaging of PCI. After having been treated with Hyperbaric oxygen therapy, antibiotics, endoscopic biopsy or operation, 9 patients got good therapeutic effect. Conclusion： EUS was very useful for evaluation of PCI. Wider application of EUS may lead to the more frequent detection of this currently rare disorder.