关键词: 急性缺血性肠病, 螺旋CT, 门静脉积气, 肠壁积气, 诊断

Abstract: Objective To investigate the application of CT scan in diagnosis of patients with acute ischemic bowel disease（AIBD）. Methods 20 patients with acute ischemic bowel disease were recruited in our hospital between June 2014 and June 2017,and all of them were checked-up by German SIEMENS Emotion 64 layer spiral CT scan. The data of spiral CT scan was analyzed retrospectively. All patient received fiber colonoscopy. Results Out of the 20 patients with AIBD,the site of ischemic enteropathy was at small intestine in 9 patients（jejunum in 5 patients,ileum in 4）,at ileocecal area in 3 patients（at terminal ileum and ascending colon segments）,at colon in 8 patients（at transverse colon in 3 patientss,at hepatic flexure of colon in 2 patients,at splenic flexure of colon in 1 patients,at descending colon in 1 patient,and at sigmoid colon in 1 patient）;all patients had portal gas accumulation,and 13 of them showed extensive gas accumulation in the portal vein and the hepatic vein,presenting the shadow of the dendritic gas,and in other 7 cases,CT showed a gas shadow at the distal hepatic vein;all patients showed intestinal wall gas accumulation,and there were bubble like low density shadows in the lesion area,a single gas bubbles in 10 patientss,multiple gas bubbles in 7 patients,and band shaped bubbles in 3 patients;CT showed that there was a low density shadow in the intestinal wall;CT showed the thickening and edema of the intestinal wall in 14,bowel dilation in 6,and abdominal effusion in 4;10 patients were scanned by enhanced CT examination and the intensification of the intestinal wall and mesentery in the intestinal segment of the enhanced lesion was weakened,and the lamination was characterized by a ring target and a halo sign;all patients received second CT scan,and they showed different degree of absorption in the portal vein and intestinal walls,e.g. completely absorbed in portal vein in 4 patients,obvious absorption in 9,a small amount of absorption in 4 patients,and no significant change in 3 patients,and pneumatosis was completely absorbed in intestinal segment in 5 patients,obvious absorption in 7 patients,absorption in 6 patients,and no significant change in 2 patients. Conclusion The manifestation of CT examination in patients with AIBD is characteristic,mainly by portal vein and intestinal wall gas accumulation, which might help the diagnosis in clinical practice.

Key words: Acute ischemic bowel disease, Spiral CT, Portal vein gas accumulation, Intestinal wall gas accumulation, Diagnosis