20 KB206 KB17 KB199220252006Bešlić, ŠerifLincender, LidijaSofić, AmelaVrcić, Dunjaštevilka:2letnik:407 stranistr. 67-72ISSN:1318-2099COBISSID:21601753URN:URN:NBN:SI:doc-SETXLLR3enAssociation of Radiology and OncologyRadiology and oncology (Ljubljana)Črevesna perforacijadiagnostikaInjuriesIntestinal PerforationperforacijaprebavilaRadiographyradiološka diagnostikaStomachTomografija radiografska, računalniškaTomography, X-Ray ComputedUltrasonographyŽelodecEarly radiological diagnostics of gastrointestinal perforation|Background. The goal is to present the possibilities of radiological procedures and the early detection of gastrointestinal perforation as a commoncause of acute abdomen. Methods. During one year period, in emergency conditions, we evaluated 20 patients with gastrointestinal perforation. Nativex-ray, ultrasound and CT of abdomen were performed on all patients, and on some of them with per os administration of 250 ml contrast, ultrasound was performed with 3, 5 MHz probe on a Siemens machine. CT scans were done on the multi row detector computed tomography (MTDC) Volume Zoom , Siemens with fourrows of detectors and 2.5 mm width. All patients were admitted with clinical symptoms of acute abdomen. Results. A group of 20 evaluated patients consisted of 8 (40%) women and 12 (60%) men of 41 as average age. The youngestpatient was 14, and the eldest 67 years old. 7 (35%) had stomach perforation and 10 (50%) duodenum perforation. There was also a traumatic colon transversal perforation in one case, in the second was stitches rupture after the stomach operation and the third was the sigma perforation caused by the malign process. Out of all above mentioned cases, in 18 (90%) cases perforation occurred spontaneously and in 2 (10%) cases artificialy. Native x-ray of abdomen showed free air in the abdominal cavity in 16 (80%) cases. Ultrasound gave positive results on free liquid in 18 (90%) and CT scan revealed both free liquid and air in 20 (100%) cases. (Abstract truncated at 2000 characters)Izhodišča. Namen raziskave je bil predstaviti radiološke preiskave pri zgodnjem odkrivanju gastrointestinalne perforacije, ki je pogost vzrok akutnega abdomna. Metode. V obdobju enega leta smo nujno obravnavali 20 bolnikov z gastrointestinalno perforacijo. Pri vseh bolnikih smo opravili rentgensko slikanje ter ultrazvočno in CT preiskavo. Nekateri bolniki so opravili rentgensko preiskavo tudi z zaužitjem 250 ml kontrasta. Ultrazvočno preiskavo smo naredili z 3,5 MHz sondo in Siemensonovim aparatom; CT preiskavopa s štiri listnim računalniškim tomografom Volume Zoom in 2,5 mm širine. Vsi bolniki so imeli klinične znake akutnega abdomna. Rezultati. V skupini 20 obravnavanih bolnikov je bilo 8 (40%) žensk in 12 (60%) moških, povprečna starost je bila 41 let (od 14 do 67). 7 (35%) jih je imelo predrtje želodca in 10 (50%) dvanajsternika. V enem primeru smo ugotovili predrtje transverzalnega dela debelega črevesa po poškodbi, v enem predrtje želodca po operaciji in v enem predrtje sigmoidnega črevesa zaradi malignega procesa. Pri18 (90%) bolnikih je predrtje nastalo spontano. Rentgenska preiskava trebuha je pokazala nivoje prostega zraka v 16 (80%) primerih, ultrazvočna preiskava prosto tekočino v 18 (90%) in CT preiskava oba znaka bolezni v vseh primerih. Zaključki. Zgodnje prepoznavanje gastrointestinalne perforacije je izjemno pomembno, saj običajno zahteva kirurško zdravljenje. Ob anamnezi je ševedno nativno rentgensko slikanje trebuha prva preiskava. Z razvojem novejših digitalnih aparatov, kot sta ultrazvok in CT, pa lahko natančno opredelimo zgodnje znake gastrointestinalne perforacije. V naši raziskavi smo ugotovili, da je ultrazvočna preiskava zelo koristna pri odkrivanju proste tekočine, s CT-jem pa smo ugotovili prosto tekočino in nivoje zraka v trebuhu tudi v tistih primerih, kjer jih ultrazvok in rentgensko slikanje nista pokazalaTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaDruštvo radiologije in onkologije