腹内疝影像诊断医学课件.ppt

腹内疝影像诊断;腹内疝定义;腹内疝的分型;根据发生原因　;根据疝的结构 ;A:paraduodenal 十二指肠旁B:foramen of winslow 网膜孔C:intersigmoid 乙状结肠间的D:pericecal 盲肠周围E:transmesenteric 肠系膜缺口疝F:retroanastomotic 吻合口后间隙;不同类型腹内疝的临床和影像学表现;左侧十二指肠旁疝;左侧十二指肠旁疝示意图;左侧十二指肠旁疝;Axial CT scans demonstrate bowel whin the bowel loops interposed between the stomach and pancreas ,some mass effect on the posterior stomch wall ,thickened bowel wall,and engorged mesenteric vessels.;A:axial contrast-enhanced CT scan in 11-year-old boy shows small-bowel loops(arrow) between stomach and pancreas.B: A:axial contrast-enhanced CT scan in 28-year-old man shows small-bowel loops(white arrow) behind pancreas(P) black arrow indicates stomach .;C:axial contrast-enhanced CT scan in 36-year-old man shows small-bowel loops(arrow) displaying inferior mensteric vein(arrowhead) to left .D:coronal construction of contrast-enhanced CT deta set in 28-year-old man shows small-bowel loops between transverse colon(T) and left adrenal gland(arrow).;A: contrast-enhanced CT scan of the upper abdomen shows a saclike mass of dilated jejunal loops between the pancreatic head (P) and stomach.The descending mesocolon(D) and stomach are displaced laterally.The dilated inferior mesenteric vein is located at the anterior border of the encapsulated loops.B:CTscan obtained 20mm a shows crowed and engorged mesenteric vessels(arrow) at the fossa of Landzert(L) 。J(jejunal loops),S(stomach),arrowhead(the inferior mesenteric vein );C:CT scan of the midabdomen shows the inferior mesenteric vein(arrowhead).This vessel is a landmark for the inferior mesocolon.Which is located at the anteromedial border of the encapsulated jejunal loops(J).D:diagram(coronal view) of the surgical findings shows that the fossa Landzert is 4cm in diameter(arrowhead);E:unenhanced axial CT scan in 35-year-old men show envidence of small-bowel obstruction of herniated contents as multiple loops of dilated small bowel(arrow)with fluid-fluid levels noted.D:缆绳征;右侧十二指肠旁疝