每日一例:陈旧性创伤性膈疝1例

2022-09-12 放射沙龙 放射沙龙

陈旧性创伤性膈疝X线病例分析。

女性,41岁。咳嗽半月,时有胸闷,两年前外伤史。

X线胸片:右中下肺密度增高,中上肺见多个液平,右膈抬高,膈面及肋膈角消失,纵隔左移,右侧多发肋骨骨折(图1A)。

 图1A 纵隔左移,右侧多发肋骨骨折CT平扫:右侧胸廓明显扩大,纵隔影明显受压推移,右胸外侧见肠管影及网膜影,肠管扩张并气液平,上至肺尖,右肺受压不张,部分肺组织疝入右侧胸腔(图1B,1C)。

 

图1B,1C 右肺受压不张,部分肺组织疝入右侧胸腔右膈肌断裂回缩内移增厚,呈条带状软组织密度似“飘带征”;腹腔肠管、网膜及部分肝脏通过膈肌裂口疝入胸腔呈“领口征”(图2)。

 
图2 右膈肌断裂回缩增厚,呈条带状软组织密度影由于膈肌破裂位于右外侧,肠影及网膜影聚集肝右外侧,肝脏明显受压推移,肝下缘肠管扩张积液伴气液平,肠壁增厚。

 

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    2022-03-03 amyloid
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