空回肠盲端型肠闭锁9例分析  

Clinical Analysis on 9 Cases of Jejunoileal Atresia of Blind End Type

作　　者：唐耕熳 刘文英[1] 李福玉[1] 胡廷泽[1] 郎诗民[1] 钟麟[1] 

机构地区：[1]四川大学华西医院小儿外科,610041

出　　处：《伤残医学杂志》2001年第3期3-5,共3页Medical Journal of Trauma and Disability

摘　　要：目的:探讨先天性空回肠盲端型(Ⅲ型)肠闭锁的可能病因、病变的宫内演变过程、临床表现的共同点与多样性。方法:回顾性分析9例手术证实的空回肠盲端型肠闭锁新生儿病例,收集其发病时间、症状、体征、影像学表现、手术所见及病理组织学检查,结合文献报告,对其病变进行分析。结果:患儿均于生后24h内表现症状,主要为呕吐,腹胀,部分有胎便排出。X线检查显示肠梗阻征象,钡灌肠可见胎儿型结肠。术中见系膜小肠某处断开,两端盲闭,肠系膜多有V型缺损,部分远侧盲端内壁可见息肉样物。结论:先天性空回肠盲端型闭锁可能主要由宫内肠套叠所引起,闭锁发生在胚胎不同时期,可出现不同的表现而可能带来诊断上的困难。Objective: To investigate the possible cause, intrauterine development and clinical features of jejunoileal atresia of blind end type (type III). Methods: 9 neonatal cases of jejunoileal atresia of blind end type were analyzed. The duration before admission, symptoms, signs, imaging features, surgical explorations and pathological findings were gathered and the literature was reviewed. Results: Symptoms were presented within 24 hours postmaternally and mainly presented as vomiting and abdominal distention, and some had defecation of meconium. X-rays suggested the intestinal obstruction and colon of fetal pattern could be seen on diluted barium enema. In operation, atresia of mesenteric intestine could be seen with two blind ends and V shaped defect of the mesentery. Some polypoid structures were seen attached on the inner facet of the distal blind end. Conclusion: Intrauterine intussusception might be the main possible cause of congenital jejunoileal atresia of blind end type. Different intrauterine stage for onset could result in different manifestation and so bring about difficulties on diagnose.

关 键 词：肠闭锁 新生儿 宫内肠套叠 

分 类 号：R714.431[医药卫生—妇产科学]