少儿期迟发性肠旋转不良的诊治体会

目的 总结延迟发病的肠旋转不良少儿期的临床特点和诊断治疗经验.方法 对我院1998年至2008年临床诊断明确并经手术治疗的23例迟发性肠旋转不良患者的临床资料进行回顾性分析.结果 23例患者均经过立位腹部平片或透视检查;9例行上消化道钡餐检查,2例行辅助钡灌肠检查,20例行腹部多普勒超声检查,13例行腹部CT扫描.术前确诊18例,确诊率为78.3%.全部病例经拉德(Ladd)手术治疗.结论 迟发性肠旋转不良临床表现多样,诊断困难;小肠扭转、肠坏死是死亡的主要原因.治疗以传统的Ladd手术为主,且对此疾病早诊断、早手术是提高治愈率的关键.

Congenital intestinal malrotation in children

Objective To summarize reasonable therapeutic measures by analyzing the characteristics of tardive intestinal malrotation in childhood. Methods Clinical data of 23 definitely diagnosed cases of intestinal mal-rotation from 1998 to 2008 were studied retrospectively. Results All of 23 patients were processed through plain ab-dominal radiograph;9 were examined with barium meal;2 were examined with barium enema;20 were examined by abdominal Doppler and 13 were examined by abdominal computer tomography. There were 18 patients who got final diagnosis preoperatively and the rate of final diagnosis was 78.3%. All of the cases were cured with Ladd's operative method. Conclusion Because tardive intestinal malrotation has various clinical manifestations,it is more difficult to diagnose than congenital intestinal malrotation in children. The main causes of death are intestinal volvulus and/or necrosis. At present,surgery is a traditional therapeutic way. Ladd procedure is the main traditional way to treat mal-trotation.