【摘要】 目的 探讨结石性肠梗阻的诊断、治疗。方法 比较腹部平片，B超、CT的诊断优势及诊断率。随访患者，了解不同处理方式的效疗。结果 腹部平片术前诊断率20%(4/20)，结合CT确诊率上升至70%(14/20)，腹腔镜成功治疗2例。10例胆十二指肠瘘患者，7例行单纯肠切开取石术，平均随访2年无复发及并发症。结论 CT对结石性肠梗阻有较高诊断价值。腹腔镜手术是安全和可行的;合并胆十二指肠瘘者，单纯行肠切开取石术是可行的。特殊部位结石的治疗，内镜是可以选择的方法。

    关键词 结石性肠梗阻 诊断 治疗

    Diagnosis and management of calculous ileus:a report of20cases

    Liu Xingyuan，Li Hua，Zhang Wenfeng

    Department of General Surgery，the People’s Hospital of Jangjin，Jiangjin402260.

    【Abstract】 Objective To study the diagnosis and management of calculous ileus.Methods comparied the advantages and accuracy of abdominal X-ray，ultrasound and computerized tomography(CT)in diagnosis;followed up patients to decide results of different managements.Results The preoperative diagnostic rate of abdominal X-ray was20%which up to70%by combined ultrasound and CT;2cases were successfully performed laparoscopy surgery;seven in ten cases gallstone ileus only performed simple enterolithotomy.The patients were followed-up for2years and all seven patients remained asymptomatic.Conclusion CTfindings confirm the diagnosis and led to a prompt and directed surgical intervention.laparoscopy surgery is a safe and feasible treament;simple enterolithotomy is appropriate in most patients.For stone in especial site such as duodenum sigmoid ......