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- W2319281495 abstract "はじめに：消化管穿孔症例の初診時CT所見につき検討し，穿孔部位の診断，治療法の選択において参考となる所見の抽出を試みたので報告する．方法：2000年1月から2008年1月までに当院で経験した消化管穿孔症例180例を対象とし，CT所見と穿孔部位，治療法をretrospectiveに検討した．CT所見は客観性と普遍性を重視し，評価しやすい所見として腸管外free air（以下，FA）と腹水貯留に着目した．結果：FAの検出率は上部，小腸，大腸それぞれ97.0，56.0，78.6％であった．十二指腸水平部下縁より頭側のFAは，上部，小腸，大腸それぞれ97.0，52.0，66.1％で，上部で有意に検出率が高く，尾側のFAは18.2，24.0，58.9％で，大腸で有意に検出率が高かった．尾側で前腹壁腹膜から離れた深部に存在するFAは，上部，小腸，大腸それぞれ1.0，16.0，51.8％で，尾側深部FA所見で大腸穿孔と診断した場合の感度と特異度はそれぞれ51.8％，96.0％であった．腹水の所見は，貯留の程度，部位ともに穿孔部位を判定する手がかりとはならなかったが，上部穿孔の保存的治療成功群では，肝表面腹水5 mm以下かつ尾側腹水少量以下で，24時間後のCTで腹水の増量はなかった．考察：CTにおけるFAの存在部位は穿孔部位の予測に，腹水の量と経時的変化は上部消化管穿孔の保存的治療の適応を決定するうえで有用であり，CTは消化管穿孔の治療戦略を立てるうえで有用であると考えられた．" @default.
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- W2319281495 date "2009-01-01" @default.
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- W2319281495 title "The Utility of Computed Tomography on Diagnosis of the Alimentary Tract Perforation" @default.
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