华法林过量致自发性小肠壁内血肿的MSCT表现(1)
摘 要：目的 探討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。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。结果 7患者例均出现弥漫性肠壁环形增厚，其中空肠4例、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、分层，黏膜下层密度增高;增强扫描可见“靶征”;2例出现小肠肠壁积气，7例均伴有肠腔狭窄、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、腹腔积血，其中4例并发肠梗阻。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、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。早期诊断对患者的治疗及预后有很重要的临床意义。
关键词：华法林;小肠壁内血肿;体层摄影术;X 线计算机
中图分类号：R574.5;R816.5 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.21.047
, http://www.100md.com
文章编号：1006-1959(2018)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：Objective 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 jejunum 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 density. Enhanced CT scanning can be seen as "target sign"; intestinal wall pneumatosis was detected in 2 cases; all 7 cases were accompanied by stenosis of intestinal cavity and dilatation of proximal small bowel，all of them had increased density around the small bowel and the corresponding mesenteric area， and had hemoperitoneum hemorrhage， among them， 4 cases were complicated with intestinal obstruction.Conclusion For patients with underlying diseases who have been treated with warfarin anticoagulation for a long time， develops sudden abdominal pain， vomiting， and melena， with prolonged coagulation time and typical CT manifestations， should be stronglyconsidered of spontaneous intramural hematoma of small bowel， and should be conducted timely and effective handling. Early diagnosis has important clinical significance for the treatment and prognosis of patients., 百拇医药(王新宇 刘光宇)
关键词：华法林;小肠壁内血肿;体层摄影术;X 线计算机
中图分类号：R574.5;R816.5 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.21.047
, http://www.100md.com
文章编号：1006-1959(2018)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：Objective 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 jejunum 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 density. Enhanced CT scanning can be seen as "target sign"; intestinal wall pneumatosis was detected in 2 cases; all 7 cases were accompanied by stenosis of intestinal cavity and dilatation of proximal small bowel，all of them had increased density around the small bowel and the corresponding mesenteric area， and had hemoperitoneum hemorrhage， among them， 4 cases were complicated with intestinal obstruction.Conclusion For patients with underlying diseases who have been treated with warfarin anticoagulation for a long time， develops sudden abdominal pain， vomiting， and melena， with prolonged coagulation time and typical CT manifestations， should be stronglyconsidered of spontaneous intramural hematoma of small bowel， and should be conducted timely and effective handling. Early diagnosis has important clinical significance for the treatment and prognosis of patients., 百拇医药(王新宇 刘光宇)