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目的 探讨大肠癌致急性完全机械性肠梗阻的X线平片表现特征。材料与方法 搜集 3 3例曾于术前作腹部X线平片检查并经手术或纤维结肠镜病理证实为大肠癌致急性完全机械性肠梗阻病例 ,就以下X线表现进行分析 :(1)梗阻近、远侧肠管表现 ;(2 )梗阻部位改变 ;(3 )合并症X线征象。结果 梗阻发生于盲肠及回盲部平面 3例 ,仅表现为小肠梗阻改变 ;升结肠及结肠肝曲平面 6例 ,其中 5例出现盲袢综合征 ;左半结肠及直肠平面 2 4例 ,均显示一般机械性肠梗阻特点 ,其中 1例并盲袢综合征。全组3 3例中 ,14例 (42 .4% )于梗阻部位可见软组织肿块影、肠腔狭窄或局部密度增高影 ,且梗阻部位征象显示与摄片体位有关 ;6例(18.2 % )见肠穿孔或腹腔转移致腹膜炎征 ;4例 (12 .1% )可见慢性肠梗阻表现。结论 大肠癌致急性完全机械性肠梗阻X线平片检查 ,不仅可判断梗阻部位 ,部分病例还可依据梗阻部位表现判断梗阻原因。合理的摄片体位 ,有利于梗阻病因征象的显示。
Objective To investigate the characteristics of X-ray plain film in acute complete mechanical obstruction caused by colorectal cancer. Materials and Methods The following X-ray findings were analyzed in 33 patients who had undergone abdominal X-ray examination before operation and confirmed by surgery or colonoscopy pathology for acute mechanical complete intestinal obstruction caused by colorectal cancer: (1) Obstruction of proximal and distal bowel manifestations; (2) changes in obstruction sites; (3) X-ray signs of comorbidities. Results Obstruction occurred in 3 cases of cecum and ileocecal planes, only manifested as small intestine obstruction; 6 cases of ascending colon and colonic hepatic curvature, 5 cases of blind palsy syndrome; 24 cases of left colon and rectum; The characteristics of general mechanical intestinal obstruction were shown, of which 1 case was blindfolded syndrome. Of the 33 patients in the whole group, 14 (42.4%) had soft tissue masses, narrow lumens, or increased local density at the site of obstruction. The signs of obstruction were related to the position of the radiograph; 6 cases (18.2%) Peritoneal perforation or peritoneal transmission caused peritonitis sign; 4 cases (12.1%) showed chronic intestinal obstruction. Conclusion X-ray plain film examination of acute complete mechanical obstruction caused by colorectal cancer can not only determine the location of obstruction, but some cases can also determine the cause of obstruction based on the obstruction site. A reasonable camera position is conducive to the display of signs of etiology of obstruction.