[Linear or bubbly: a pictorial review of CT features of intestinal pneumatosis in adults].
[Linear or bubbly: a pictorial review of CT features of intestinal pneumatosis in adults].
复制标题
[线性或气泡：成人肠积气的 CT 特征图解]。
作者：
P. Soyer;S. Martin;M. Boudiaf;P. Malzy;F. Duchat;L. Hamzi;M. Pocard;K. Vahedi;R. Rymer
肠性肺肿是一种罕见的疾病，它是由肠壁内气体的存在所定义的。在成人患者中，肠肺病可以在各种情况下被描述。由于常规使用CT检查腹痛患者，肠性肺肿可被视为偶然发现或与肠梗死等危及生命的疾病相关。肠性肺肿在CT上可表现为两种不同的表现；一个具有囊性或气泡外观可被认为是慢性肺病，并提示良性原因，而另一个具有线性外观可被认为是一种症状，并且更经常继发于危及生命的原因。然而，这两种CT特征都不能被认为是这两类病因的典型症状。在这种情况下，分析位置、范围和相关发现（如果有的话）可能有助于区分良性和危及生命的原因。对于这些出现类似于需要手术探查的症状的腹部症状的患者，分析相关发现对于排除危及生命的肠肺病原因和避免不必要的剖腹手术的需要至关重要。对于患有已知特定疾病（如乳糜泻、慢性假性肠梗阻或其他慢性疾病）的成年患者，即使伴有气腹，也不要求进行手术探查。这篇图片回顾了成人患者肠性肺肿的CT特征，目的是让读者更熟悉这种可能具有误导性的征象。
Pneumatosis intestinalis is a rare condition, which is defined by the presence of gas within the bowel wall. In adult patients, pneumatosis intestinalis can be depicted in various circumstances. Owing to the routine use of CT to investigate patients with abdominal pain, pneumatosis intestinalis can be seen as an incidental finding or can be observed in association with a life-threatening disease such as bowel infarction. On CT images, pneumatosis intestinalis can display two different appearances; one that has a cystic or bubbly appearance can be considered as a chronic pneumatosis and is suggestive for a benign cause while the other, which has a linear appearance can be considered as a symptom and is more frequently secondary to a life-threatening cause. However, none of these two CT characteristics can be considered pathognomonic for any of these two categories of causes. In such situations, the analysis of the location, extent and, if any, associated findings may help to differentiate between benign and life-threatening causes. In these patients who present with abdominal signs that mimic symptoms that would warrant surgical exploration, the analysis of associated findings is critical to rule out a life-threatening cause of pneumatosis intestinalis and to obviate the need for unnecessary laparotomy. In adult patients with a known specific disease such as celiac disease, chronic pseudointestinal obstruction or other chronic diseases, even with accompanying pneumoperitoneum, pneumatosis intestinalis does not uniformly mandate surgical exploration. This pictorial review presents the more and the less common pneumatosis intestinalis CT features in adult patients, with the aim of making the reader more familiar with this potentially misleading sign.