ĐẶC ĐIỂM HÌNH ẢNH CẮT LỚP VI TÍNH ĐA DÃY TRONG CHẨN ĐOÁN THỦNG DẠ DÀY - TÁ TRÀNG

Abstract

Objectives: To study imaging characteristics of multislice computed tomography in diagnosing gastroduodenal perforation. Methods: A retrospective, prospective, and cross-sectional descriptive study on 83 patients who underwent multislice computed tomography scans with contrast injections and were surgically diagnosed with gastroduodenal perforation between July 2021 and June 2023. Results: The most common perforation site was the duodenal bulb in 57 patients (68.67%), and the least common was the basal - body in 3 patients (3.61%). The most common cause was ulcerative perforation in 61 patients (73.5%). Abdominal free gas signs were seen in 80 patients (96.4%). The pylorus-duodenal perforation group: Diaphragmatic sub-arch gas 64 patients (92.8%), falciform ligament sign/ligamentum teres sign 52 patients (75.4%), peri-portal free air 40 patients (58%) appeared at a higher rate than the fixed duodenal perforation group (0 - 9.1%) (p < 0.05). Retroperitoneal cavity gas was common in the 5 patients fixed-segment duodenal perforation group (54.5%). Focal wall defect 68 patients (81.9%), concentration of extraluminal air bubbles 66 patients (79.5%), focal wall thickening 75 patients (90.4%), perivisceral fat stranding 78 patients (94%), extraluminal fluid 55 patients (66.3%), focal wall poor absorption 73 patients (88%) were present with a high incidence in the puncture site groups and there was no difference between groups. Conclusion: Abdominal free gas occurs at a high rate in gastroduodenal perforation; the gas distribution varies between gastroduodenal perforation sites.