新生儿腹股沟嵌顿性斜疝的彩色多普勒超声诊断价值

目的分析新生儿腹股沟嵌顿性斜疝的声像图特征,评价彩色多普勒超声诊断价值。方法对11例新生儿腹股沟嵌顿性斜疝行超声检查,观察疝块的各项指标,包括大小、内部回声、形态及周边情况等,并用CDFI观察疝内容物的血流信号。结果新生儿腹股沟嵌顿性斜疝声像图多表现为阴囊内肿块,疝囊内容物以肠袢最为常见,超声可显示增厚的肠壁及肠腔内无回声区(积液)。CDFI:疝内容物血流信号较少。结论彩色多普勒超声能清晰地检出新生儿嵌顿性斜疝,是有效的诊断方法,对嵌顿性斜疝的诊断、鉴别诊断及预后评估有重要价值。     

高频超声和彩色多普勒血流显像在腹股沟斜疝诊断中的临床应用研究

目的:研究腹股沟斜疝临床诊断中用高频超声和彩色多普勒血流显像法的价值。方法:以2016年6月到2019年5月本院接诊的腹股沟斜疝病患50例为对象,并对其施以高频超声和彩色多普勒血流显像检查。综合分析50例病患的检查结果,同时对患者的声像图特征进行总结。结果:50例病患超声诊断的结果提示腹股沟斜疝,和手术病理诊断的结果相符,其中,绞窄性疝有3例、易复性疝有29例、嵌顿性疝有14例、难复性疝有4例。超声声像图显示,腹股沟部位腹壁层中存在疝囊,且疝囊近端经疝囊颈和腹腔相通,而远端则是盲端。经高频彩超检查可见,若疝内容物是肠管,可见肠腔内容物、肠管管壁特点和气体回声等,且肠壁存在多条的彩色血流,若内容物是大网膜,可见筛网状的回声团亦或者是簇状的杂乱回声团,同时伴有斑点状的彩色血流。对于绞窄疝和嵌顿疝病患来说,其疝中彩色血流均发生改变。精索与疝囊后壁相贴,腹壁下动脉位于疝囊后方以及疝囊颈内侧。结论:于腹股沟斜疝的临床诊断工作当中合理运用高频超声和彩色多普勒血流显像法,能够将内容物性质清楚地显示出来,并能为患者手术方案及时的提供重要指导,另外,彩色多普勒血流显像法还能为疾病的鉴别诊断、预后评估与内容物损害程度的判定等提供较为丰富的影像学信息,建议推广。     

高频彩超诊断腹股沟斜疝的临床价值

目的 探讨腹股沟斜疝的高频彩超声像图特征与临床价值。方法 高频彩超检查25例腹股沟斜疝均经手术病理证实。结果 腹股沟斜疝表现为腹股沟区腹壁层内见疝囊，其近端通过疝囊颈与腹腔相通，远端为边界光整的盲端。高频彩超显示疝内容物为肠管时呈多层中高回声，肠壁有多条彩色血流；内容物为大网膜时呈不均质点状中高回声，伴斑点状彩色血流。嵌顿疝内的彩色血流有不同程度改变。腹壁下动脉在疝囊的后方、疝囊颈的内侧。精索紧贴疝囊的后壁。结论 高频彩超能显示腹股沟斜疝内容物性质。彩色血流动态与嵌顿疝有一定关系，对临床判断内容物损害程度有一定价值。     

高频超声及彩色多普勒诊断腹股沟疝的临床价值

目的探讨高频超声及彩色多普勒血流显像对腹股沟的诊断价值。方法运用高频超声及彩色多普勒血流显像技术对100例腹股沟疝患者进行检查。结果100例腹股沟疝均经手术确诊,其中16例难复性斜疝发生嵌顿形成绞窄性疝。90例为腹股沟斜疝,10例为腹股沟直疝。经超声检查确诊96例;误诊4例,其中1例疝内容物为大网膜,疝囊内有渗出液,超声误诊为鞘膜积液,2例绞窄性腹股沟斜疝超声误诊为腹股沟脓肿,1例女性腹股沟斜疝患者误诊为股疝。结论高频超声可清晰地获得腹股沟疝的二维图像,利用彩色多普勒血流显像可观察疝性包块内的血流分布情况,从而提示腹股沟疝有无嵌顿及绞窄,为临床决定手术方式提供重要的参考意见。     

彩色多普勒超声在小儿嵌顿性腹股沟疝中的应用

目的 探讨彩色多普勒超声（CDS）对小儿嵌顿性腹股沟疝的应用价值。方法 应用CDS对20例嵌顿疝患儿进行检测。结果 应用CDS诊断嵌顿疝敏感性100％;特异性100％;确定疝内容物为卵巢或含气肠管的标准性性100％。CDS显示疝内容物、睾丸血流灌注与手术结果相符。结论 CDS可显示疝内容物、睾丸的形态变化的血流灌注,是嵌顿疝首选的检查方法。     

女性婴幼儿腹股沟卵巢嵌顿斜疝一例报告

卵巢疝常见于婴幼儿,属于婴幼儿急症,因症状及体征不典型,容易误诊和漏诊。该文报道1例婴幼儿卵巢疝病例,患儿2岁,因"家属发现其左侧腹股沟肿物伴疼痛2 d"入院。主诊医师根据其临床症状及彩色多普勒超声检查诊断为左侧嵌顿性腹股沟斜疝(左卵巢嵌顿疝?),明确无手术禁忌证后及时实施左侧嵌顿性腹股沟斜疝松解+修补术,术程顺利,术中成功保留患儿卵巢,术中诊断为左侧嵌顿性腹股沟斜疝(左卵巢嵌顿疝)。婴幼儿腹股沟斜疝易发生嵌顿,女性患儿嵌顿内容物可能为卵巢,卵巢嵌顿坏死对女性影响极大,因此,早期诊断、及时手术,安全有效地保留卵巢极为重要。     

腹外疝的超声表现及临床价值

目的 比较几种腹外疝的超声表现，探讨超声在腹外疝的临床应用价值。方法应用超声和彩色多普勒技术检测24例腹壁，腹股沟和阴囊肿物并与手术结果对照，分析疝的部位和疝内容物的超声与临床表现。结果腹股沟疝10例，股疝5例，切口疝5例，腹壁疝3例。二维超声可分辨肠管或大网膜等不同的疝内容物。疝未嵌顿时彩色多普勒可见血流信号，嵌顿疝则无血流信号。结论腹股沟疝，股疝，切口疝和腹壁疝的发生因患者的性别，年龄和手术史等不同而异。超声能显示疝环，疝囊，疝内容物和疝外被盖等四个部分，尤其能对疝内容物及其血液供应情况在手术前加以鉴别。     

超声对女性婴儿腹股沟疝伴子宫或卵巢嵌顿的诊断价值

目的 探讨超声对女耍腹股沟籼伴子宫或卵巢嵌顿的早期诊断价值。方法 分析38例经手术证实的女婴腹股沟疝患者的二维及彩色多普勒超声图象特征。结果 超声确诊的38例搞例中,20例伴有子宫或卵巢嵌顿,超声表现为典型的子宫、卵巢声像图,且嵌顿的子宫或卵巢外形大于不伴有子宫或卵巢嵌顿者。结论 女婴腹股沟疝患者,尤其是60d以下的小婴儿,超声检查对其早期诊断具有重要价值。     

超声诊断右侧腹股沟疝卵巢嵌顿1例

<正>患儿女,40 d,因触及右侧腹股沟区包块2 d就诊。超声检查:右侧腹股沟区探及大小约18 mm×13 mm团块状弱回声,与腹腔相通(图1),相通处约5 mm;内见多个囊泡状结构,最大者约8 mm×8 mm(图2),CDFI示其内可见短条样血流信号(图3)。缺损向体表突出而成,是外科常见疾病之一。由于卵巢输卵管位置前倾,可达腹前壁腹股沟管处,因此疝内容物除小肠、大网膜外,还可以是卵巢、输卵管及子宫,而且常常不易回纳,出现嵌顿,引起坏死。本例患儿疝内容物即为卵巢。当超声发现疝内容     

腹股沟斜疝及其合并症的超声诊断

目的 探讨高频超声及彩色多普勒技术在腹股沟斜疝及其合并症诊断中的临床应用价值.方法 对59例腹股沟斜疝患者术前的临床和超声表现进行回顾性分析. 结果 腹股沟斜疝59例中属可复性斜疝39例,滑动性斜疝3例,嵌顿性斜疝15例(其中嵌顿疝合并睾丸扭转1例,合并鞘膜积液3例),以及斜疝合并子宫圆韧带囊肿2例.超声诊断符合率94.92%.结论 高频超声及彩色多普勒技术能显示腹股沟斜疝内容物及其血供情况,并及时发现有无合并症,对临床的诊断和治疗均有实用价值.     

女性婴幼儿嵌顿性腹股沟斜疝致附件坏死的诊治分析

目的总结女性婴幼儿嵌顿性腹股沟斜疝致附件坏死的临床特点和治疗经验。 方法回顾性分析昆明医科大学附属昆明市儿童医院2014年3月至2018年12月收治的94例女性婴幼儿嵌顿性腹股沟斜疝患儿的临床资料,并对其临床表现、诊断方法和治疗效果进行分析。 结果94例患儿均以腹股沟区包块就诊。51例彩色多普勒超声检查考虑附件嵌顿,11例考虑肠管嵌顿,7例考虑网膜嵌顿,25例性质不定;经急诊手术证实,61例附件发生嵌顿,其中19例为附件坏死,3例为肠管嵌顿,30例自行回复;19例附件发生坏死的患儿中,17例予以切除,2例家属拒绝切除予以还纳。1例术后复发。 结论女性婴幼儿嵌顿性腹股沟斜疝附件（多为卵巢及部分输卵管）嵌顿坏死发生率相对较高,需早发现、早诊断、早治疗,以减少附件嵌顿坏死手术切除的风险;彩色多普勒超声是诊断附件嵌顿性腹股沟斜疝的重要方法。     

A 3-Month-Old Female with an Inguinal Mass

Background: Inguinal masses are a common finding among infants. The differential diagnosis of these masses in infants is broad, with inguinal hernia being the most common diagnosis in both males and females. However, the evaluation and management of males vs. females with inguinal masses is somewhat different due to the greater potential for gonad involvement in males. Objectives: The pathophysiology and management of inguinal hernias is discussed with a specific focus on inguinal hernias in females. Case Report: We present a case of a 3-month-old girl with an inguinal hernia and a mass, found to be an incarcerated ovary. Conclusions: Inguinal masses in infancy are common, with inguinal hernia being the most common cause by far. A female infant with suspected inguinal hernia should be thoroughly evaluated to determine whether ovarian content is present.     

高频超声诊断小儿腹股沟疝大网膜嵌顿伴化脓的价值

目的探讨高频超声对小儿腹股沟疝大网膜嵌顿伴化脓的诊断价值。方法回顾性分析经临床手术及病理证实的13例小儿腹股沟疝大网膜嵌顿伴化脓的声像图表现，并对其伴随的睾丸及其他并发症进行总结分析。结果误诊1例，其余12例的声像图特点为疝囊内不均质中强回声区内见多个不规则、大小不等的无回声区，可呈网格状，通过疝囊颈与腹腔相通。中强回声及无回声区内均未见血流信号。13例中12例伴有1种或多种并发症。结论小儿腹股沟疝大网膜嵌顿伴化脓具有特征性的声像图表现，高频超声可作出正确诊断，同时可检出睾丸情况及其他并发症。     

婴幼儿继发性睾丸缺血性病变的超声诊断及临床意义

目的探讨婴幼儿继发性睾丸缺血性病变的超声声像幽特征及临床意义。方法回顾分析我院1305例因阴囊急症就诊患儿的睾丸超声表现,分析睾丸缺血病因,总结其随访结局。结果62例腹股沟嵌顿疝患儿,发生继发睾丸缺血性病变25例（1．92％）,其中4例发生睾丸萎缩;睾丸扭转患儿12例（0．92％）,其中手术切除睾丸4例,随访发现睾丸萎缩3例;鞘膜积液、可复性腹股沟疝及睾丸附睾炎患儿均未发生睾丸缺血性病变。继发性睾丸缺血的声像图表现呈动念变化过程,Ⅰ期睾丸增大,Ⅱ期睾丸回声不均,Ⅲ期睾丸液化,Ⅳ期睾丸萎缩。睾丸萎缩者彩色多普勒血流图呈血流分布自正常或轻度增加到减少至淌失3个阶段。结论腹股沟嵌顿疝是婴幼儿继发性睾丸缺血性病变的主要原因,发生率高于睾丸扭转。睾丸缺血卢像图警动态变化过程,彩色多普勒血流成像显示睾丸无血流信号者,提示发生睾丸萎缩的可能,对这类患儿进行为期3个月的随访有重要的临床意义。     

Groin hernias in adults: value of color Doppler sonography in their classification.

PURPOSE: We assessed the abilities of color Doppler and power Doppler sonography to distinguish among types of groin hernias by demonstrating the inferior epigastric artery (IEA) and its relationship with the hernia sac. METHODS: Nineteen consecutive patients (14 men and 5 women), clinically diagnosed as having groin hernias and scheduled to undergo herniorrhaphy, were prospectively enrolled in this study. Ultrasound examinations were performed preoperatively with a 6-12-MHz linear-array transducer. The IEA was identified, if possible, and its relationship to the hernia sac assessed. The sonographic diagnoses were compared with the operative findings. RESULTS: There were 15 indirect inguinal hernias, 4 direct inguinal hernias, and 1 femoral hernia; 1 patient had bilateral inguinal hernias (indirect and direct). In 18 (90%) of 20 hernia cases, the trunk segment of the IEA could be visualized. In 11 (55%) of 20 hernia cases, the origin segment of the IEA could be visualized and its relationship with the hernia sac assessed. In 9 (82%) of the 11 hernia cases, hernia types were correctly diagnosed by sonography. The overall accuracy of sonography for diagnosing the type of hernia was 45% (9 of 20 hernias). CONCLUSIONS: Color Doppler sonography can accurately differentiate types of groin hernias if the origin segment of the IEA and the hernia sac can be visualized simultaneously. However, color Doppler sonography sometimes failed to visualize this segment.     

Amyand hernia: a case of an unusual inguinal herniace

Amyand hernia, named for the first person to describe an inguinal hernia containing the vermiform appendix, is an uncommon variant of an inguinal hernia. Presence of the appendix in the sac complicates the management of inguinal hernias. The appendix may be more prone to rupture when contained within a hernia sac, and herniation of an inflamed appendix into the scrotum can mimic an acute scrotum. A 50-year-old man presented with right lower quadrant abdominal pain associated with chills and anorexia. Physical examination revealed right lower quadrant tenderness and a right inguinal mass without associated skin changes. Laboratories were normal. A plain abdominal computed tomography scan for acute appendicitis showed an indirect right inguinal hernia with the appendix contained within the sac, which was incarcerated. Surgical consultation was obtained. The patient taken to the operating room, and his appendix was removed. The hernia was coincidentally repaired, and the patient was discharged soon thereafter. In cases suggestive of acute appendicitis complicating an inguinal hernia, the diagnosis of this unusual variant must be considered.