Objective To investigate the CT features and anatomic basis of peritoneal and retroperitoneal spread of primary acute duodenal inflammation. Methods Twenty-six cases of peritoneal and retroperitoneal spreading acute duodenum inflammation confirmed by gastroscopy and clinical diagnosis during January 2010 to December 2014 were collected. Then we analyzed the CT manifestations of their inflammatory features, and abdominal cavity and retroperitoneal diffusion rules. Results According to the inflammation location, in the 26 cases, there were 1 case of inflammation in the descending part of duodenum, 1 in the horizontal part of duodenum, 15 in both the descending and horizontal parts of duodenum, 7 in both the horizontal and ascending parts of duodenum, and 2 in all the descending, horizontal and ascending parts of duodenum. According to the peritoneal and retroperitoneal spreading locations of acute duodenum inflammation, there were 20 cases of transverse mesocolon and mesenteric root swelling, 17 cases of enlargement of the head of pancreas, 6 cases of ascending colon and ileocecal swelling, 5 cases of anterior and posterior renal fascia of right kidney and perinephric fascia of right kidney swelling, 3 cases of effusion between the anterior and posterior renal fascia and lateral cone fascia of right kidney, 1 case of transverse mesocolon, mesenteric root, and the right pelvic swelling, and 1 cases of abdominal pelvic effusion. Conclusions Acute duodenum inflammation is mainly located in the descending and horizontal parts of duodenum. Different duodenal segments have different degrees of inflammation, while the horizontal segment is the most obvious. Inflammation involving two segments and above can be combined with ulcers. The inflammation infiltrates through transverse mesocolon, mesenteric root, anterior and posterior renal fascia of the right kidney, and spreads to the abdominal and retroperitoneal space, which causes the ascending colon and ileocecal swelling. The effusion can be observed in retroperitoneal space, anterior and posterior renal fascia and abdominal cavity.
Citation：
LIMingying, DENGKaihong. CT features and anatomic basis of peritoneal and retroperitoneal spread of primary acute duodenal inflammation. West China Medical Journal, 2017, 32(1): 51-55. doi: 10.7507/1002-0179.201506073
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- 1. 任建林, 焦兴元. 现代消化病诊疗学. 北京: 人民军医出版社, 2007: 155-157.
- 2. 袁宏, 马洪升. 幽门螺杆菌感染小鼠动物模型研究进展. 华西医学, 2007, 22(3): 683-684.
- 3. 萧树东, 巫协宁, 莫剑忠, 等. 江绍基胃肠病学. 上海: 上海科学技术出版社, 2001: 387-388.
- 4. 巫北海, 罗天友, 黄学金, 等. 活体形态学: 腹盆上卷. 北京: 科技出版社, 2006: 134-167.
- 5. 李冬飞, 范国华. MSCT 多平面重组技术在十二指肠降部病变诊断中的价值. 实用放射学杂志, 2015, 31(12): 2046-2049.
- 6. 温彪, 赵奎. 药物联合钛夹治疗十二指肠球后溃疡出血疗效观察. 海南医学, 2015, 26(24): 3677-3679.
- 7. 张晓鹏. 胃肠道 CT 诊断学. 沈阳: 辽宁科学技术出版社, 2001: 189.
- 8. Gore M, Balfe M, Aizenstein I, et al. The great escape: interfascial decompression planes of the retroperitoneum. AJR Am J Roentgenol, 2000, 175(2): 363-370.
- 9. 郭俊渊. 现代腹部影像诊断学(上册). 北京: 科技出版社, 2001: 270-272.
- 10. 孙春锋, 缪小芬, 陆健, 等. 急性胰腺炎在腹膜后扩散的 CT 表现与肾筋膜减压平面的关系. 临床放射学杂志, 2009, 28(4): 518-521.
- 11. 徐莹, 余晨, 陈业媛, 等. 多层螺旋 CT 小肠造影在诊断肠结核与克罗恩病中的价值研究. 实用放射学杂志, 2015, 1(8): 1273-1277.
- 12. 刘静, 焦俊, 张英俊, 等. 小肠肠壁增厚的多层螺旋 CT 小肠造影征象分析和诊断价值. 临床放射学杂志, 2015, 34(12): 1919-1923.
- 13. 李玉清, 陈子力, 张泽坤. 十二指肠球部结核 1 例. 临床放射学杂志, 2004, 23(9): 766.
- 14. 陈灏珠. 实用内科学. 12 版. 北京: 人民卫生出版社, 2005: 554-555.
- 15. 郑贤应, 曹代荣, 游瑞雄, 等. 嗜酸性粒细胞胃肠炎的 CT 与 MRI 诊断价值. 临床放射学杂志, 2015, 34(3): 411-414.
- 16. 朱龙, 董素贞. 十二指肠间质瘤的 CT 诊断. 中国实用医药, 2012, 7(16): 39-40.
