先天性肥厚性幽门狭窄X线诊断

目的：总结分析先天性肥厚性幽门狭窄的X线表现。方法：对15例患儿进行钡餐造影。结果：胃腔扩张9例，胃排空延迟15例，幽门管细长、狭窄15例，鸟嘴征10例，肩样征5例，蕈伞征4例，幽门小突征8例。结论：钡餐造影能对先天性肥厚性幽门狭窄作出明确诊断。     

先天性肥厚性幽门狭窄X线分析

先天性肥厚性幽门狭窄是新生儿期较常见的疾病，钡餐透视检查是最简单、最普遍、最准确的X线诊断方法。本文就我院18例经手术证实的新生儿先天性肥厚性幽门狭窄的钡餐透视X线表现进行分析，讨论钡餐检查对新生儿先天性肥厚性幽门狭窄的X线诊断价值。     

儿童先天性幽门厚狭窄的上消化道造影诊断

目的探讨上消化道造影检查诊断儿童先天性幽门肥厚狭窄的临床应用价值。方法回顾性分析我院2007年6月至2013年2月经手术证实的先天性幽门肥厚狭窄病例43例,男29例,女14例,年龄16～52d,中位年龄23d。所有患儿术前均进行了上消化道造影检查,总结其上消化道造影的影像学表现。结果43例上消化道造影检查可见幽门管变细,幽门管直径为（1.90±0．20）mm,幽门管变长为（15．7±0．3）mm;可见典型的线样征、双轨征、鸟嘴征、肩样征及菌伞征,胃腔扩张,蠕动增强,钡剂排空延迟。结论上消化道造影检查在诊断儿童先天性幽门肥厚狭窄方面具有较高的临床价值。     

婴儿幽门肥厚性狭窄的不常见X线表现

婴儿幽门肥厚性狭窄(IHPS)是导致婴儿期呕吐的最常见原因之一，系环行肌肥厚引起幽门管狭窄，其最佳诊断手段至今仍数钡餐检查，现报道一组婴儿幽门肥厚性狭窄并侧重其不常见型X线表现进行探讨。     

婴儿先天性幽门狭窄的X线检查及诊断

目的：探讨小儿先天性幽门狭窄Ｘ线检查方法及其Ｘ线表现的有关病理基础。方法：回顾１６例经手术证实的先天性幽门狭窄的患儿的Ｘ线检查及Ｘ线表现和手术所见。其中有６例有Ｂ超检查结果。结果：明显胃扩张１４例,胃排空延迟１６例。６例Ｂ超结果与手术所见相同。其中３例幽门管呈鸟嘴样梗阻。结论：（１）肩样征提示幽门肌肥厚明显。（２）本病必须与其它疾病鉴别。如先天性胃窦隔膜性狭窄。同时还应排除幽门暂时痉挛造成的假象。（３）Ｘ线与超声结合能为外科手术提供必要的依据。     

先天性肥厚性幽门狭窄的X线与超声诊断比较应用

本文6例经X线钡餐及超声诊断肥厚性幽门狭窄患者,均经手术证实.回顾分析超声及X线表现,并与手术结果对照.报告如下.     

先天性肥厚性幽门狭窄的X线与超声诊断

先天性肥厚性幽门狭窄是新生儿常见的消化道疾病。X线与B超检查，均有助于本病的诊断，二者各具有特色。互为补充。复习文献，结合我院经手术证实的65例患儿，对术前钡餐与B超检查诊断情况进行对比分析。     

婴儿肥厚性幽门狭窄的不典型X线表现

婴儿肥厚性幽门狭窄的不典型Ｘ线表现潘恩源叶滨滨靳家文陈培青杨舒泉张可仞王练英笔者报道一组婴儿肥厚性幽门狭窄（ＩＨＰＳ）并侧重其不典型Ｘ线表现进行探讨。材料与方法中国医科大学第二临床学院１９８７～１９９４年８年中共诊治ＩＨＰＳ４４１例，其中因临床诊断不...     

先天性肥厚性幽门狭窄的X线诊断（附24例分析）

对24例先天性肥厚性幽门狭窄钡餐造影的X线征象进行分析，并对产生这些征象的病理征象进行分析。对本病钡餐造影的体位、摄片观察时间及超声学进行了讨论。     

32例克隆氏病的X线诊断

目的：探讨克隆氏病的病理变化和X线造影特征与鉴别诊断，方法：收集经手术和病理证实的32例克隆氏病造影资料进行回顾性分析和总结；结果：主要X线表现“靶心”或“牛眼”征，“锯齿”征，“卵石”征，“假憩室”征，节段性狭窄，溃疡形成，肠梗阻或瘘道形成，局部肿块形成；结论：根据病变部位、分布特点、病变周围改变及伴随征象结合临床资料可作出正确的诊断和鉴别诊断。     

Postoperative ultrasonography changes of the pylorus in infants with hypertrophic pyloric stenosis

Infantile hypertrophic pyloric stenosis (IHPS) is a common condition affecting infants. Ramstedt pyloromyotomy procedure remains the standard of surgical treatment of IHPS till today. Postoperative ultrasonography of the pylorus is indicated in patients with persistent vomiting after pyloromyotomy to assess pyloric morphology, gastric emptying and excludes other associated conditions or complications that may present with this clinical picture.     

In vivo visualization of pyloric mucosal hypertrophy in infants with hypertrophic pyloric stenosis: is there an etiologic role?

OBJECTIVE: Infantile hypertrophic pyloric stenosis (IHPS) is a common condition which presents in infants at 2-12 weeks of postnatal life, and whose cause remains obscure. Multiple associated abnormalities have been recognized within the external hypertrophied pyloric muscle layer, but the internal component of the pyloric mucosa has received scant attention in the literature to date. Our purpose in this study was to show that pyloric mucosal redundancy is a constant finding in infants with IHPS, to discuss its possible cause, and to explore the hypothesis of a relationship between pyloric mucosal redundancy and the development of IHPS. MATERIALS AND METHODS: We identified 102 consecutive infants with surgically confirmed IHPS and determined the thickness of the pyloric mucosa compared with the thickness of the surrounding hypertrophied muscle. Fifty-one infants who did not have pyloric stenosis served as controls. RESULTS: Mean mucosal thickness in patients with IHPS approximated mean muscle thickness, with a ratio of 0.89. In infants with IHPS, the pyloric mucosa constitutes approximately one third of the cross-sectional diameter of the pyloric mass and fills and obstructs the pyloric canal. CONCLUSION: Mucosal redundancy is a constant associated finding in IHPS. Although the origin of the redundancy and a cause-and-effect relationship are difficult to establish, our findings support the hypothesis that hypergastrinemia may be implicated in the pathogenesis of IHPS, and suggest that mucosal thickening could be implicated as one of the initiating factors in its development.     

Use of ultrasound in 187 infants with suspected infantile hypertrophic pyloric stenosis

The diagnostic efficacy of ultrasound (US) in the diagnosis of infantile hypertrophic pyloric stenosis (IHPS) was evaluated, with particular attention paid to whether prematurity, age or weight correlate significantly to the sonographic measurements. The medical records of 187 infants with suspected IHPS were reviewed retrospectively. Eighty-seven had an US examination with details of the pylorus. Fifty-nine of these gave a positive diagnosis. The US criteria for a positive diagnosis were pyloric muscle thickness (PMT)>or=3 mm and pyloric muscle length (PML)>or=17 mm. The mean overall PMT was 4.14 mm and mean overall PML was 18.99 mm. Premature infants had a lower mean PML (17.8 mm) than the term infants (PML mean 19.3 mm); however, this was not significant (t-value 1.92, P=0.062). The sensitivity and specificity of PMT was 91 and 85%, respectively, and of PML 76 and 85%, respectively. The ability of US to diagnose IHPS using our criteria was significant (t-value, PMT 14.93 and PML 6.89; P<0.0001). There was no significant correlation between age, weight or prematurity and a sonographic diagnosis of IHPS (Pearson's coefficient<0.3). Therefore, the same US criteria should apply irrespective of prematurity, age or weight. Borderline PMT and PML measurements necessitate repeat US or alternative imaging.     

胃良性肿瘤脱垂于十二指肠(球)的X线诊断(附8例报告)

目的提高对胃良性肿瘤脱垂于十二指肠(球)的X线表现、机制、脱垂分型和鉴别诊断的认识。方法回顾性分析和研究了采用钡餐胃肠道造影和胃镜检查,并经手术和病理证实的胃良性肿瘤脱垂十二指肠(球)8例。结果胃良性肿瘤脱入十二指肠(球)的X线表现有①十二指肠(球)的充盈缺损和十二指肠降段充盈缺损;②牵引粘膜桥征和幽门管增宽;③肿瘤表面粘膜显示光整和龛影－“牛眼征”;④胃整体形态的改变;⑤肿瘤脱垂与回纳现象;⑥原发肿瘤的部位分布胃窦部肿瘤6例,胃体部和胃底部肿瘤各1例。病理诊断－脱垂于十二指肠球内平滑肌瘤4例,脂肪瘤和神经鞘瘤各1例,脱垂于十二指肠降部平滑肌瘤2例。结论可靠的X线诊断征象有①十二指肠(球)的充盈缺损;②牵引粘膜桥征;③幽门管增宽;④胃整体形态的改变。     

胃溃疡的相关特殊X线征象分析

目的:分析胃溃疡的特殊X线表现,提高对胃溃疡特殊X线表现的认识和诊断水平。方法:回顾性分析8例具有特殊X线征象胃溃疡的X线资料,病例均经病理活检或手术证实。结果:本组病例全部是良性胃溃疡,由于其具有酷似恶性胃溃疡的特殊X线征象,故诊断正确率低:明确诊断1例,疑似诊断3例,误诊4例。结论:通过对胃溃疡X线征象的充分分析与随访观察,可以提高对胃溃疡特殊X线表现的认识能力。     

New method for evaluation of perigastric invasion of gastric cancer by right lateral position CT

The purpose of this study was to evaluate usefulness of right lateral position CT in determining invasion of gastric cancer into adjacent organs. We assessed whether position shift, a change in the relative location of a gastric tumor and adjacent organs between the supine position and right lateral position CT, was a useful sign for absence of invasion into perigastric organs. In 37 patients with advanced gastric cancer with doubtful invasion into adjacent organs by conventional CT after 500 ml water oral intake, additive right lateral CT was performed. Of 24 cases of lesions in the gastric body, 16 had a position shift and no invasion into adjacent organs at surgery (T3), and 8 had no position shift and invasion (T4). The accuracy was 100%. Six gastric cardial and 7 pyloric tumors showed no position shift, and 3 cardial and 2 pyloric tumors were proved to be noninvasive (T3). The accuracy of cardial and pyloric tumor was 50 and 71%. We concluded that position shift may be useful in the diagnosis of invasion of adjacent organs by gastric cancer, limited to in cases with gastric body cancer.Correspondence to: T. Shirakawa     

Malignant pyloric stenosis caused by cancer in para-pyloric ectopic pancreas

Gastrointestinal symptoms with epigastric pain, nausea and loss in weight occasionally occur in patients with ectopic pancreas. Although ectopic pancreas is often found in the stomach, carcinoma in this ectopy is rare. This paper reports a case of pancreatic carcinoma arising in ectopic pancreas located in the gastric wall and causing pyloric obstruction. Malignant pyloric obstruction was the only radiographic sign. Microscopic examination led to the final diagnosis.     

全胃切除空肠移置代胃人工幽门括约肌重建术治疗胃癌的远期疗效评价

目的观察胃癌病人行全胃切除空肠移置代胃人工幽门括约肌重建术的远期疗效。方法连续5年以上对全组106例患者的营养状况、生存率、术后并发症发生率以及术后生活质量等情况进行定期随访。结果本组患者5年生存率42.5%,碱性反流性食管炎的发生率为0.9%,术后5年胆石症发生率为5.66%,生活质量优良率为89.6%。结论全胃切除、代胃及人工幽门括约肌重建术治疗进展期胃癌有较好的远期疗效。     

Hypertrophic stenosis of the pylorus. Ultrasound and traditional diagnosis. Comparison of methods

Hypertrophic pyloric stenosis (HPS) is the most frequent cause of abdominal surgery during the first months of life. A new diagnostic approach to this type of pathology is given by ultrasound examination which offers the opportunity to perform a precise study of pyloric muscle thickness, pyloric diameter width and pyloric muscle length. Ultrasound provides a quick diagnostic tool sparing radiation exposure to the patient. X-ray study is only to be reserved to the few cases in which clinical and ultrasound data are doubtful and--in all instances--to rule-out other possible causes of gastric outlet obstruction. We report 20 infants (14 males and 6 females) referred with clinical suspicion of HPS. This diagnosis has been confirmed by ultrasound in 12 cases, suspected in 1 and excluded in 7 cases. Upper gastrointestinal tract series confirmed the presence of HPS in 13 cases; discovered a huge gastroesophageal reflux in one and showed normal findings in 6 cases.