ABSTRACT
Objective:To summarize the CT imaging features of obturator hernia.Methods:From July 2009 to May 2019, the clinical and CT imaging features of 26 cases with obturator hernia diagnosed by multi-slice spiral CT(MSCT) were retrospectively analyzed.The locations of hernia sac, contents of hernia and intestinal obstruction were observed by multi-planer reconstructions(MPR).Results:There were 5 cases of bilateral obturator hernia, 9 cases of right obturator hernia and 12 cases of left obturator hernia.The contents of hernia were small intestine in 19 cases, mesentery in 9 cases and bladder in 5 cases.There were 3 cases of bilateral small intestine obturator hernia, 7 cases of right and 9 cases of left small intestine obturator hernia, presented with abruptly collapse and narrowing of small intestinal cavity at the entrance of obturator canal.The small intestine was herniated between the external obturator muscle and the pubic muscle and adductor brevis, between the upper and lower bundles of external obturator muscle and the internal obturator muscle and superior pubic sulcus.There were 15 cases of small intestinal obstruction, including 9 cases of incarcerated small intestinal obstruction and 6 cases of strangulated small intestinal obstruction, of which 15 cases presented with small intestinal effusion, 3 cases with a little accumulation of gas, 14 cases with small intestinal wall edema and 2 cases with intestinal wall defect.The dilatation effusion and pneumatosis could be found in the proximal small intestine, of which 14 cases with gas-liquid level, 12 cases with small intestinal wall edema and mesenteric edema.There were 4 cases of bilateral mesenteric obturator hernia, 2 cases of right mesenteric obturator hernia and 3 cases of left mesenteric obturator hernia.There were 2 cases of right mild bladder obturator hernia and 3 cases of left mild bladder obturator hernia, presented with cystic water-like density at the entrance of obturator canal.Conclusion:MSCT reconstruction can intuitively display imaging features of obturator hernia, which has a rather high diagnostic value for small intestinal ischemic, necrosis and perforation.
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ObjectiveTo study the effect of TCM diagnostic method flow reconstruction and optimized management in the mass injuries emergency previewing reception.MethodsWorking mode of TCM optimized receiving and dispatching flow were established and enforced.Results27 batch of 216 cases were received by emergency previewing reception in 2009～2010.Compared to 2009,patient dispatching time was shorten by 3.0 min,area dispatching time was shorten by 2.9 min in average.Emergency treatment satisfaction was elevated from 65％ to 95％ and rescue successful rate was increased from 82.3％ to 89.6％.ConclusionTCM diagnostic method flow reconstruction and optimized management improved the level of management of in the mass injuries emergency previewing reception and obtained better results.
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Objective To assess the prediction value of nonbronchial systemic arterial supply in hemoptysis patients with non-enhanced CT. Methods Fifty-six consecutive patients with hemoptysis underwent non-enhanced CT. Thickness of pleural adjacent to parenchymal lesion larger than 3 mm was regarded as index of nonbronchial systemic arterial supply. Conventional angiography was used as the standard of reference. CT findings were compared with those of conventional angiography. The sensitivity, specificity, and accuracy of CT for predicting nonbronchial systemic arterial supply were assessed. Results The sensitivity, specificity and accuracy of CT for predicting nonbronchial systemic arterial supply were 72.73%, 95.00% and 91.11%, respectively. Sensitivity was higher when nonbronchial systemic arterial supply located in superolateral and posterolateral lung, and lower in anteromedial and inferior lung. Specificity and accuracy were high for predicting nonbronchial systemic arterial supply in every locations. Conclusion Non-enhanced CT can predict nonbronchial systemic arterial supply in patients with hemoptysis, which is helpful for selecting angiography and embolization.