华法林过量致自发性小肠壁内血肿的MSCT表现-医学信息.PDF

医学信息2018 年11 月第31 卷第21 期 Medical Information Nov. 2018 Vol. 31 No.21 诊疗技术 窑 疗技术窑 法林过量致自发性小肠壁内血肿的MSCT 表现 新宇 刘光宇 渊攀枝花市中心医院放射影像科 四川 攀枝花 617067冤 摘 要 目的 探讨华法林过量引起自发性小肠壁内血肿的MSCT 表现及其诊断价值遥 方法 回顾性分析我院经临床确诊的7 例 自发性小肠壁内血肿的MSCT 表现 其中6 例行全腹增强CT 扫描遥 结果 7 患者例均出现弥漫性肠壁环形增厚 其中空肠4 例尧 回肠3 例 5 例表现为肠壁全层密度增高 另2 例表现为肠壁水肿尧分层 黏膜下层密度增高曰增强扫描可见野靶征冶曰2 例出现小肠 肠壁积气 7 例均伴有肠腔狭窄尧近端小肠腔扩张 均出现受累小肠周围及相应肠系膜区密度增高尧腹腔积血 其中4 例并发肠梗 阻遥 结论 对于有基础疾病长期使用华法林抗凝治疗的患者 突发腹痛尧呕吐及黑便 伴有凝血时间明显延长 且有典型的CT 表 现 应高度怀疑有自发性小肠壁内血肿的可能 进行及时有效的处理遥 早期诊断对患者的治疗及预后有很重要的临床意义遥 关键词 华法林曰小肠壁内血肿曰体层摄影术曰X 线计算机 中图分类号 R574.5 曰R816.5 文献标识码 A DOI 10.3969/j .issn.1006-1959.2018.21.047 文章编号 1006-1959渊2018冤21-0161-04 Spontaneous Intramural Hematoma of Small Bowel Secondary to Excessive Warfarin Therapy: MSCT Manifestations and Its Clinical Value WANG Xinyu, LIU Guangyu (Department of Radiology, Panzhihua Central Hospital, Panzhihua 617067 Sichuan,China) Abstract Obj ective Toinvestigate the MSCT features and clinical value of spontaneous intramural hematoma of small bowel caused by warfarin overdose,and to discuss the value of MSCT in its diagnosis.Methods A total of 7 patients with spontaneous intramural hematoma of small bowel caused by warfarin overdose in our hospital were included in this study.All 7 patients employed plain MSCT scan ，and 6 of them received contrast -enhanced CT scan of the whole abdomen.The clinical data were retrospectively analyzed. Results Diffused annular thickening of bowl wall ，involving j ej unum 4 cases and ileum3 cases ，was seen in all 7 patients. In 5 cases, the density of the whole layer of intestinal wall was increased ，while the other 2 cases showed intestinal wall edema, stratification and increased submucosal