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英文誌(2004-)

Journal of Medical Ultrasonics

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1983 - Vol.10

Vol.10 No.04

Original Article(原著)

(0244 - 0250)

緊急腹部超音波検査法

Emergent Ultrasonic Examination in Patient with Acute Abdominal Pain

冨田 周介1, 工藤 正俊1, 藤見 勝彦1, 新垣 光彌1, 小森 英司1, 藤堂 彰男1, 北浦 保智1, 浜田 充生2, 大谷 雅美2, 字井 一世2, 藤本 敏明2

Syusuke TOMITA1, Masatoshi KUDO1, Katsuhiko FUJIMI1, Mitsuya SHINGAKI1, Eiji KOMORI1, Akio TODO1, Yasutomo KITAURA1, Michio HAMADA2, Masami OHTANI2, Kazuyo UI2, Toshiaki FUJIMOTO2

1神戸市立中央市民病院内科, 2神戸市立中央市民病院中央検査室

1Department of Internal Medicine, Kobe Central Municipal Hospital, 2Department of Central Laboratory, Kobe Central Municipal Hospital

キーワード : ultrasonic examination, abdominal emergency

To define the role of ultrasound in evaluating acute abdominal pathology, emergent ultrasonic examination prior to surgery or autopsy was performed in 160 patients. Diagnosis of acute cholecystitis was done with following five findings; expansion of the gallbladder, containing stones and debris in it, thiekening and sonolucent layer of the wall. Ultrasound can predict acute cholecystitis in 83 out of 86 patients. In 22 out of 34 patients with choledocholithiasis, stones in the extrahepatic bile duct were visualized with longitudinal sonogram. In three out of four patients with choledochal cyst, local or generalized dilation of the extrahepatic bile duct was visualized. There were five patients with pancreatitis indicating surgical intervention. In three out of these five patients, pancreatic pseudocysts were visualized. In the others, peripancreatic effusion and pancreatic lithiasis was visualized in each patient. All six cases with bowel obstruction including two of strangulating type were correctly diagnosed by ultrasonic findings of fluid-filled distended loop with Kerckring's fold. In six out of eight patients with hepatoma admitted for intraperitoneal bleeding, hepatic masses were determined. In three out of four patients with ruptured abdominal aortic aneurysm, pulsatile echo free space communicating with the aorta was visualized. In four out of five patients with acute dissecting aneurysm, fluttering intimal flap within the abdominal aorta was delineated.
We conclude that ultrasonic examination should be performed as the first choice in patient with acute abdomen.