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肠系膜静脉血栓形成引起的肠系膜梗死难于确诊,应与其它原因的肠梗死鉴别。临床所见和术中表现典型。多数作者强调动脉造影对确定肠系膜梗死病源学以及动脉梗塞部位的重要性。然而,动脉造影一般不能确诊肠系膜静脉血栓形成,并且难以与非梗塞性梗死相鉴别。已证实对比加强CT扫描有用于确定门静脉血栓形成或门脉海棉状血管瘤,并作为诊断静脉性肠系膜梗死有价值和无损伤性检查方法。本文报道4例经对比加强CT诊断的肠系膜梗死,CT可用做术前(病例1和2)、术中(病例3)或保守治疗后随访。
Mesenteric infarction caused by mesenteric vein thrombosis is difficult to diagnose, should be distinguished from other causes of intestinal infarction. Clinical findings and intraoperative performance typical. Most authors emphasize the importance of angiography in determining the pathogenesis of mesenteric infarcts and the location of arterial infarction. However, arteriography generally fails to confirm mesenteric venous thrombosis and is difficult to differentiate from non-infarcted infarcts. Contrast enhanced CT scans have been shown to be useful in the determination of portal vein thrombosis or portal fibromyalgia and as a valuable and noninvasive method of diagnosing venous mesenteric infarction. This paper reports 4 cases of mesenteric infarction diagnosed by contrast enhanced CT, which can be used for preoperative (cases 1 and 2), intraoperative (case 3) or follow-up after conservative treatment.