Multislice Spiral CT in Adult Abdominal Anaphylactoid Purpura:Diagnosis and Treatment Follow-up
10.3969/j.issn.1005-5185.2015.05.012
- VernacularTitle:多层螺旋CT对成人腹型过敏性紫癜的诊断及疗效评价
- Author:
Xiaojie CHENG
;
Jihua JIAN
;
Ruoqin CHENG
;
Qun LIU
;
Qingdong YAO
;
Diyu LU
- Publication Type:Journal Article
- Keywords:
Purpura,schoenlein-henoch;
Abdominal pain;
Tomography,spiral computed;
Treatment outcome;
Diagnostic errors;
Gastroscopy;
Adult
- From:
Chinese Journal of Medical Imaging
2015;(5):369-372
- CountryChina
- Language:Chinese
-
Abstract:
PurposeTo evaluate multislice spiral CT (MSCT) in diagnosing abdominal anaphylactoid purpura (AAP), and to explore its role in treatment follow-up.Materials and Methods Clinical and MSCT data of 13 patients with confirmed AAP were retrospectively analyzed. All patients underwent abdominal CT scan and thin layer reconstruction. Upper endoscopy was performed in 8 patients prior to treatment. MSCT was performed in 10 patients and endoscopy in 4 patients posttreatment, then clinical and CT features were compared to pretreatment findings.Results In pretreatment CT scan, single segment bowel involvement was found in 2 cases, multisegmental bowel involvement in 10 cases, and no positive finding in 1 patient. The duodenum and jejunum were involved in 8 patients and stomach in 5 patients. The diseased bowel wall showed swelling and thickening with decreased attenuation and homogeneous luminal narrowing with equivocal lining and double loop sign. Infiltration was found in 10 patients, small ascites in 3 patients. Patients were misdiagnosed as acute pancreatitis in 2 cases, acute cholecystitis, small bowel obstruction and peritonitis in 1 case respectively. Of 13 patients, five patients were cured, and the other 8 patients were improved. The clinical symptoms including rash, abdominal pain, occult blood, leukocytosis, vomiting, melena, urine occult blood were improved (χ2=5.59-18.33,P<0.05 orP<0.01). Post treatment CT showed significant improvement of bowel edema and infiltration (P<0.01). There was no statistically significant difference in change of ascites (P>0.05).Conclusion MSCT findings of AAP are nonspecific. CT diagnosis is difficult before skin rash. Combining CT characteristics of multisegmental bowel edema and clinical manifestations is helpful. CT examination can effectively follow up treatment response.
