在上胃肠孔穿孔修复后,进行术后成像,以检测泄漏
Mary Junak1, Devashish Joshi1, Victoria R Rendell1
1Department of Surgery, University of Wisconsin, Madison, Wisconsin.
The Journal of surgical research
|January 17, 2026
概括
光镜上部胃肠道系列 (fUGI) 与计算机断层扫描 (CT) 相比,在胃或十二指肠穿孔修复后排除早期泄漏的可靠性更高. 为了改善术后泄漏检测,需要标准化的成像协议.
科学领域:
- 胃肠病学 胃肠病学
- 手术紧急情况 手术紧急情况
- 诊断成像 诊断成像 诊断成像
背景情况:
- 胃和十二指肠穿孔是具有高发病率和死亡率的外科紧急情况.
- 手术后泄漏是手术修复后的一个严重并发症.
- 目前缺乏用于成像模式或患者选择的指导方针.
研究的目的:
- 为了比较光镜上部胃肠道系列 (fUGI) 和计算机断层扫描 (CT) 用于术后泄漏检测.
- 评估fUGI和CT在识别维修后泄漏方面的性能.
主要方法:
- 对168名经过胃或十二指肠穿孔手术修复的患者进行回顾性队列研究 (2011-2023年).
- 评估了手术干预,术后成像 (fUGI与CT) 和临床结果.
- 通过放射性证据,排水特性和/或手术内发现的定义后维修泄漏.
主要成果:
- 术后泄漏发生在20.2%的患者中.
- fUGI显示泄漏检测的灵敏度为56.3%,负预测值 (NPV) 为91.9%.
- CT显示灵敏度为44.4%,NPV为75.6%;对比方案没有标准化.
结论:
- 与CT相比,fUGI的灵敏度和NPV在排除早期泄漏方面略高.
- 这两种成像方法在术后泄漏检测方面都有局限性.
- 标准化成像协议是改善患者护理的必要条件.
相关概念视频
Esophageal Perforation-II: Clinical Manifestations and Management
512
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
512
Upper GI Series: Barium Swallow
1.5K
The Barium Swallow Study, or a Barium Esophagogram, is a diagnostic imaging method used to visualize the upper gastrointestinal (GI) tract, including the esophagus, stomach, and small intestine. It employs barium sulfate, a radiopaque contrast material, to provide clear images of the upper digestive system, helping to identify abnormalities, diseases, or structural issues.
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
1.5K
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
577
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
577
Appendicitis-II: Diagnostic Studies and Management
525
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
525
Radiological Investigation III: Pulmonary Angiogram and PET Scan
411
Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
411
Imaging Studies V: Intravenous Urography and Retrograde Pyelography
1.1K
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
1.1K


