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복부 둔산에 의한 장관 파열 위치 진단을 위한 CT 소견
CT Features for the Detection of Bowel Perforation Sites by Blunt Abdominal Trauma

연재우    (인하대학교 의과대학 진단방사선과학교실  );
  • 초록

    Purpose : We evaluated the CT criteria useful for the diagnosis of the site of bowel perforation in patientswith this or mesenteric injury caused by blunt abdominal trauma. Materials and Methods : CT findings of 26patients with blunt abdominal trauma were retrospectively analyzed by two observers who were unaware of operativefindings, and the results of their analysis were compared with those findings. Twenty cases of bowel perforationfound at the jejunum (8), ileum (9), and colon (3), and six cases of mesenteric injuries were confirmed byoperation. We evaluated CT findings of 1) segmental bowel wall thickening, b) focal mesenteric fat infiltration, c) loculated fluid collection and d) extraluminal air adjacent to the bowel, and in addition analyzed thelocations of ascites and free air, and the associated injuries of solid organs. Results : The most common findingat the site of bowel perforation was segmental bowel wall thickening (17 cases), followed by focal mesenteric fatinfiltration (12 cases), loculated fluid (12 cases) and extraluminal air ajacent to the bowel (9 cases). Segmentalbowel wall thickening was present at 34 sites, and the perforations were confirmed at 17 of these(50%). Focalmesenteric fat infiltration was present at 19 sites ; the perforations were proven at 12(63%). Loculated fluidcollections were confirmed at 12/20 sites(60%), and extraluminal air adjacent to the bowel at 9/12(75%). Thepositive predictive value of criteria a, b, d, c) was 100%, and the positive predictive values of a, b, c) and a, d) were 60 and 67%, respectively. We observed ascites in 16 cases and intraperitoneal free air in 8 cases, thelocations of ascites and free air did not, however, significantly correlate with the perforation sites. Conclusion: Extraluminal air adjacent to the bowel was the most specific criterion, and segmental bowel wall thickening wasthe most sensitive criterion. of all criteria, the finding 'a, b, c, d' most accurately predicted the site ofbowel perforation.


  • 주제어

    Intestines, CT .   Intestines, perforation .   Abdomen, injuries.  

  • 참고문헌 (18)

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    16. 복부수상후 소장파열의 전산화 단층촬영 소견 , 오진환;김영주;박중화;심수연;성기준 , 대한방사선의학회지 / v.32,pp.757-761,
         
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  • 이 논문을 인용한 문헌 (1)

    1. 1998. "CT Diagnosis of Traumatic Small Bowel Perforation without Pneumoperitoneum or Oral Contrast Leak" 대한방사선의학회지 = Journal of the Korean Radiological Society, 39(4): 757~762     

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  • 연재우 (1)

    1. 1998 "속립성 폐결핵 환자에서 단순흉부촬영영상 결절들의 연속 변화" 대한방사선의학회지 = Journal of the Korean Radiological Society 38 (6): 1037~1043    

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