目的:探讨盲部憩室炎的诊断和手术方式的选择。方法:回顾性分析18例盲部憩室炎的临床资料,包块临床表现、腹部体征、辅助检查、手术方式及随访结果。结果:18例均有右下腹疼痛及右下腹压痛。术前诊断困难,仅通过钡灌肠结肠造影和结肠镜确诊各1例,误诊为急性阑尾炎12例、阑尾周围脓肿1例、回盲部肿瘤3例。憩室单发3例,多发性15例,其中2个憩室9例,3个憩室6例。单纯憩室切除9例,回盲部切除2例;右半结肠切除7例。全组患者均获治愈,无严重并发症发生。结论:盲肠憩室炎的临床特征与急性阑尾炎相似,极易误诊为急性阑尾炎等。术中应注意探查,避免遗漏病变。根据憩室具体情况决定手术方式。
ObjectiveTo evaluate efficacy and safety of treatment of Kommerell diverticulum with endovascular technique.MethodThe retrospective analysis was made on the preoperative clinical data, surgical treatment, and postoperative status of patient with Kommerell diverticulum who underwent the endovascular treatment in the Department of Vascular Surgery, Xuanwu Hospital of Capital Medical University.ResultsAccording to the different types and clinical symptoms, the effective endovascular treatment was adopted. The thoracic endovascular aortic repair and coil embolization of Kommerell diverticulum were successfully performed. The postoperative aortic blood flow was unobstructed and the aneurysmal lesion was completely isolated. No endoleakage and intracranial and upper limb ischemia were occurred. The operation time was 55 min and the blood loss was 20 mL. The patient was discharged on day 6 after the operation. No endoleakage, dizziness, and upper limb numbness were found following-up for 12 months.ConclusionFor patient with different types of Kommerell diverticulum and different symptoms, who could be treated by appropriate endovascular treatment and it is effective and safety.
目的:探讨MRI不同检查方法对十二指肠乳头旁憩室(periampullary diverticulum,PAD)的诊断价值。方法:应用MRI多序列检查方法诊断PAD23例,并进行分析。结果:T1WI显示为囊状低信号影,与十二指肠相通者1例,其余22例表现为不均匀略低及高低混杂信号,均未明确诊断;横断位压脂T2WI显示含气液平面囊性病灶15例;冠状位FIESTA序列表现为混杂高信号或高信号影15例;呼吸触发3D MRCP表现为高或混杂高信号影16例;冠状位屏气3DCE LAVA动态增强扫描均清晰显示。其中合并胆系结石13例,胆系炎症及感染13例,胰腺炎3例,胆胰管扩张3例,十二指肠炎症3例。结论:MRI能多序列、多方位、直观、无创的清晰显示PAD的部位、大小、范围及与邻近结构的关系,同时显示胆胰疾病形态学改变。故MRI多序列检查非常必要,是PAD诊断及鉴别诊断的重要方法。
This paper aims to explore the feasibility of building a finite element model of left atrial diverticulum (LAD) using reverse engineering software based on computed tomography (CT) images. The study was based on a three-dimensional cardiac CT images of a atrial fibrillation patient with LAD. The left atrium and LAD anatomical features were accurately reproduced by using Geomagic Studio 12 and Mimics 15 reverse engineering software. In addition, one left atrial model with LAD and one without LAD were created with ANSYS finite element analysis software, and the validity of the two models were verified. The results show that it is feasible to establish the LAD finite element model based on cardiac three-dimensional CT images using reverse engineering software. The results of this paper will lay a theoretical foundation for further hemodynamic analysis of LAD.