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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。方法回顾性分析经临床确诊的6例自发性小肠壁内血肿的MSCT表现,其中5例行全腹增强CT扫描。结果 6例均出现单发弥漫性肠壁环形增厚,其中空、回肠各3例;3例表现为肠壁全层密度增高,另3例表现为肠壁黏膜下层密度增高;增强扫描可见“靶征”;1例出现小肠肠壁积气;6例均伴有肠腔狭窄、腹腔积血,均出现受累小肠周围及相应肠系膜区密度增高,其中3例并发肠梗阻。结论对于正在接受华法林抗凝治疗的患者,突发腹痛伴凝血功能异常,且有典型的CT表现,应高度警惕自发性小肠壁内血肿的可能。早期诊断对患者的治疗及预后有很重要的临床意义。
Objective To investigate the manifestations and diagnostic value of warfarin on MSCT caused by spontaneous intestinal wall hematoma. Methods Retrospective analysis of 6 cases of clinically diagnosed spontaneous intestinal wall hematoma MSCT performance, including 5 cases of full-abdominal enhanced CT scan. Results In all cases, diffuse annular thickening of single bowel was found in 3 cases, with 3 cases of empty and ileum. The density of the full thickness of the intestinal wall was increased in 3 cases and the density of the submucosal wall in the other 3 cases was increased. “Target sign”; 1 case of small intestine intestinal wall gas; 6 cases were accompanied by intestinal stenosis, abdominal hematocele, were involved affected small intestine and the corresponding mesenteric area density increased, of which 3 cases of intestinal obstruction. Conclusions For patients undergoing anticoagulation with warfarin, sudden abdominal pain with coagulation abnormalities and typical CT findings should be highly alert to the possibility of spontaneous intrahepatic hematoma. Early diagnosis of patients with treatment and prognosis of very important clinical significance.