新生儿消化道穿孔X线表现及病因与预后研究

目的　深入了解新生儿消化道穿孔X线表现 ,并对发病部位与发病原因及预后评估进行探讨 .方法　对照分析了 2 4例临床手术资料与X线征象 .结果　各种位置X线检查发现气腹 2 3例 ,大量气腹 7例 ,中量气腹 11例 ,少量气腹 5例 .气腹的X线征象除膈下游离气体外 ,在卧位或水平侧位片还可见足球征 13例 ,镰状韧带征 12例 ,铅笔征或Rigler氏征 10例 ,“黑三角征”3例 .气腹以外的其它征象是 :胃泡影消失 6例 ,肠管少气 11例 ,肠管充气增多12例 ,肠管无气 1例 ,肠间隙增宽 12例 ,肠壁积气 5例 ,腹腔液体增多 15例 ,外围肠管可见气粪混合征 3例 .肠穿孔原因 :胃壁先天性肌层缺损 5例 ,各种先天性小肠畸形 6例 ,结肠和直肠畸形 4例 ,坏死性小肠结肠炎 7例 ,胎粪性腹膜炎 1例 .结论　X线检查仍然是发现新生儿消化道穿孔的重要首选方法 ,对穿孔的原因和预后评估有一定帮助

Perforation of Alimentary Tract in Neonate:Radiologic Findings,Causes and Prediction of Prognosis

Objective To know about the radiologic findings of perf oration of alimentary tract in different projections, and to discuss the etiology of disease and prediction of prognosis. Methods Clinical records and radiologic findings of 24 cases were analyzed retrospectively. Results 23 pneumoperitoneum were detected by radiologic examinations in different projections. The common radiologic findings of pneumoperitoneum included free air below diaphragm, football sign (13 cases), falciform sign(12 cases),Rigler sign(10 cases) in AP supine and black triangle sign in lateral beam projection(3 cases). Other signs included disappearance of gastric bulb(6 cases), less gas of intestine(11 cases), increasing gas of intestine(12 cases), gasless of intestine(1 case),separation of bowl loops(12 cases),pneumatosis intesinalis(5 cases),ascites(15 cases), air-stool mixing in colon(3 cases). Causes of perforation of alimentary tract: Defects of gastric musculature(5 cases),congenital malformations of small intestine(6 cases), malformations of colons and rectums(4 cases), necrotizing enterocolitis(7 cases) and meconium peritonitis(1 case). Conclusions It is an important method and first choice to detect perforation with radiologic examination, and it could also help to presume causes and predict prognosis.