《腹内疝CT表现》PPT课件.ppt

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1、CaseOldwomanwithchronic,episodicabdominalpainCTimagesCTimagesWhichfindingsarepresent?Venousthrombosis?Mesenterictwisting?Displacedbowelloops?Whichfindingsarepresent?Withintheleftupperabdomen,thereisthinsacfilledwithsmallbowelwithswirlingvesselsidentifiedwithinit.Whichchoiceisthemostlikely

2、diagnosis?A,ParaduodenalherniaB,ForamenofWinslowherniaC,TransmesentericherniaD,TransomentalherniaE,CongenitalmalrotationParaduodenalHerniaWhat’sparaduodenalherniathemostcommontypeofinternalhernia(53%)congenitalhernia,herniasacasymptomatic,colickyepigastricorperiumbilicalpainM:F=3:1hasleft

3、andrighttwosubtypes,theformeraccountsforabout3/4HowparaduodenalherniahapenedLeftparaduodenalherniaoccurwhenbowelprolapsesthroughLandzert'sfossa,anaperturepresentinapproximately2%ofthepopulation.Landzert'sfossaislocatedbehindtheascendingorfourthpartoftheduodenumandisformedbytheliftingupofa

4、peritonealfoldbytheinferiormesentericveinandascendingleftcolicarteryastheyrunalongthelateralsideofthefossa.HowparaduodenalherniahapenedRightsubtypeoccurwhenbowelprolapsesthroughWaldeyer'sfossabelowtotheascendingduodenum,andtotherightsideofthemesocolon.CTDiagnosis(Leftparaduodenalhernia)Ax

5、ialCTscansdemonstratebowelwhinthebowelloopsinterposedbetweenthestomachandpancreas,somemasseffectontheposteriorstomachwall,thickenedbowelwall,andengorgedmesentericvessels.CTDiagnosis(Leftparaduodenalhernia)axialcontrast-enhancedCTscanin11-year-oldboyshowssmall-bowelloops(arrow)betweenstoma

6、chandpancreasCTDiagnosis(Leftparaduodenalhernia)axialcontrast-enhancedCTscanin28-year-oldmanshowssmall-bowelloops(whitearrow)behindpancreas(P)(blackarrowindicatesstomach)CTDiagnosis(Leftparaduodenalhernia)axialcontrast-enhancedCTscanin36-year-oldmanshowssmall-bowelloops(arrow)displayingin

7、feriormenstericvein(arrowhead)toleft.CTDiagnosis(Leftparaduodenalhernia)coronalconstructionofcontrast-enhancedCTin28-year-oldmanshowssmall-bowelloopsbetweentransversecolon(T)andleftadrenalgland(arrow)CTDiagnosis(Leftparaduodenalhernia)CTscanofthemidabdomenshowsthein