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BMJ：结肠充气CT扫描后阴囊气肿-案例报道

2017-05-09 xing.T MedSci原创

结肠充气CT扫描阴囊气肿腹痛
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这种结肠充气CT扫描罕见的并发症突出了阴囊与腹膜之间存在解剖性交通。这种情况下可以采用抗生素进行保守治疗。该患者收住院进行密切观察，当患者临床症状恶化需要进行剖腹探查。

患者为一名79岁的男性，因进行结肠充气CT扫描5小时后出现了突发严重全腹疼痛3小时而就诊。

体格检查时发现生理参数正常，下腹部压痛，可见阴囊皮下气肿（如图1上部所示）。急诊CT扫描发现为阴囊气肿继发于结肠穿孔，气体通过左腹股沟管进入阴囊（如图1下部所示）。

图1（上）显示皮下阴囊气肿的照片。（下）相应的CT斜冠状影像显示空气沿腹股沟管进入阴囊（如箭头所示）

这种结肠充气CT扫描罕见的并发症突出了阴囊与腹膜之间存在解剖性交通。这种情况下可以采用抗生素进行保守治疗。该患者收住院进行密切观察，当患者临床症状恶化需要进行剖腹探查。

原始出处：

Stephan Edey, et al. Pneumoscrotum following computed tomography pneumocolon.BMJ 2017; http://www.bmj.com/content/357/bmj.j1825

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    2017-06-21 gaoxiaoe

    #BMJ#

    0

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    2018-01-06 vera_1210

    #阴囊#

    0

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    2017-09-05 yanjie6253_56072842

    #阴囊气肿#

    0

  4. 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encryptionId=aa2e5463db, topicName=CT扫描)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ed3819951332, createdName=ms6323715314570549, createdTime=Thu May 11 08:49:00 CST 2017, time=2017-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196120, encodeId=fb351961205c, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJicFGXtYqfjGiaibNdjOiaRgkexnXiciaDeXaLiaKicovcicDugdYwRPSnQj3FlfXBwVLB5ANB9PGFyB0kraQ/0, createdBy=35b01663265, createdName=1ddf3e1dm99(暂无匿称), createdTime=Wed May 10 08:05:12 CST 2017, time=2017-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196077, encodeId=66fc1960e730, content=少见啊，保守不见效再加重应手术。, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, 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objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Wed May 10 01:13:18 CST 2017, time=2017-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195959, encodeId=439e1959594a, content=谢谢分享学习啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Wed May 10 00:32:54 CST 2017, time=2017-05-10, status=1, ipAttribution=), 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    2017-05-11 ms6323715314570549

    #CT扫描#

    0

  5. 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    2017-05-10 1ddf3e1dm99(暂无匿称)

    学习了谢谢分享

    0

  6. 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    2017-05-10 王国安

    少见啊，保守不见效再加重应手术。

    0

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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/27/136abcae2f8e58d33f28258f76f49b4f.jpg, createdBy=7e701980206, createdName=王国安, createdTime=Wed May 10 07:10:29 CST 2017, time=2017-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=196022, encodeId=411819602268, content=学习了，临床医疗面对的病历太丰富了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=d41c2055892, createdName=184****9840, createdTime=Wed May 10 06:31:03 CST 2017, time=2017-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195970, encodeId=74411959e029, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Wed May 10 01:13:18 CST 2017, time=2017-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195959, encodeId=439e1959594a, content=谢谢分享学习啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Wed May 10 00:32:54 CST 2017, time=2017-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195911, encodeId=58d519591124, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Tue May 09 21:00:58 CST 2017, time=2017-05-09, status=1, ipAttribution=)]
    2017-05-10 184****9840

    学习了，临床医疗面对的病历太丰富了。

    0

  8. 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objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Wed May 10 01:13:18 CST 2017, time=2017-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195959, encodeId=439e1959594a, content=谢谢分享学习啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Wed May 10 00:32:54 CST 2017, time=2017-05-10, status=1, ipAttribution=), 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    2017-05-10 天涯183

    非常好的文章，学习了，很受益

    0

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objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Wed May 10 01:13:18 CST 2017, time=2017-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195959, encodeId=439e1959594a, content=谢谢分享学习啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Wed May 10 00:32:54 CST 2017, time=2017-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=195911, encodeId=58d519591124, content=学习一下谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzaiabIFicf63hKvVMjL6aJlx4yX4UcXmzX9DyibCRcicq0QtCRWMaQKh8MYjE1D3EKUBopgiaGWYuqbeR/0, createdBy=0c2b1999806, createdName=三生有幸9135, createdTime=Tue May 09 21:00:58 CST 2017, time=2017-05-09, status=1, ipAttribution=)]
    2017-05-10 tanxingdoctor

    谢谢分享学习啦

    0

  10. 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    2017-05-09 三生有幸9135

    学习一下谢谢分享

    0

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