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1.
Advait Prakash Bhavesh Doshi Sangram Singh Tanmay Vyas Anvesh Jain 《African Journal of Paediatric Surgery》2015,12(1):82-85
Intussusception is a very rare cause of intestinal obstruction in neonates. It is of extremely rare occurrence among premature neonates. We present a case of 11-day-old premature neonate who presented with abdominal distension, intolerance to feeds, vomiting, significant bilious aspirate and bleeding per rectum. The initial diagnosis of necrotizing enterocolitis (NEC) led to a delay in the diagnosis. On exploratory laparotomy, it turned out to be a case of ileo-colic intussusception with Meckel''s diverticulum as a lead point. This site of intussusception (ileo-colic) and presence of a lead point among premature neonate is of exceedingly rare occurrence and very few such cases have been reported.In this article, the published work about clinical features and management on intussusceptions in premature neonates has been reviewed. The authors intend to highlight the difficulty in distinguishing the NEC and intussusception. Subtle clinical and radiological features which can help in differentiating the two conditions have been emphasized. This can avoid the delay in diagnosis and management which can prove critical. High index of suspicion with timely intervention is the key for optimizing outcome. A diagnosis of intussusception should always be considered in any preterm infant with suspected NEC. 相似文献
2.
Malignant peripheral nerve sheath tumors (MPNST) are defined as any tumor arising from a peripheral nerve or showing nerve
sheath differentiation. The majority of these tumors arise on the trunk, extremities, or head and neck region. The literature
to date has fewer than 14 cases of MPNST arising in the gastrointestinal tract, and only two cases were ever reported in the
small intestine, one of which was a recurrent disease. In this paper, we report the first US case of an MPNST arising in the
small intestine and presenting as intussusception. 相似文献
3.
M. Sachs A. Encke 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1993,378(5):288-291
Zusammenfassung Es wird über eine 43jährige Patientin berichtet, die mehrere Wochen lang über inkonstant auftretende, krampfartige Mittelbauchschmerzen klagte. Die Diagnose einer ileoilealen Invagination konnte bei der Patientin erst beim dritten stationären Aufenthalt gestellt werden. Folgende Fehldiagnosen waren während des 4wöchigen Verlaufs bei der Patientin gestellt worden: Nierenbeckenentzundung, acute Appendizitis, chronische Appendizitis und zuletzt psychosomatische Bauchschmerzen. Die Patientin wurde zunächst antibiotisch, zuletzt mit Psychopharmaka medikamentös behandelt. Schließlich wurde die Diagnose einer Invagination des Dünndarms mittels Sonographie vermutet und in der konventionellen fortlaufenden Magen-Darm-Passage röntgenologisch gesichert. Bei der Patientin wurde daraufhin eine Dünndarmsegmentresektion durchgeführt. Die enteroenterale Invagination ist im Erwachsenenalter ein sehr seltenes Ereignis, bei der meistens eine Ursache (oft Tumore) als Auslöser der Invagination ermittelt werden kann. Durch Peristaltik und Ingesta wird der nach aboral bewegte Tumor zum Motor der Invagination. Prädilektionsorte sind die Übergänge eines beweglichen zu einem retroperitoneal fixierten Darmabschnitts (z. B. Ileozökalregion). Die Sonographie des Abdomens ist die Methode der ersten Wahl bei der Diagnose einer enteroenteralen Invagination. Beim Erwachsenen ist die operative Beseitigung der Invagination und deren Ursache (meist Tumore) angezeigt.
Entero-enteric invagination of the small intestine in adultsA rare cause of abdominal distress
The present paper reports on a 43-year-old female patient who complained over a number of weeks of paroxysms of crampy pain in the mesogastrium. The diagnosis of ileoileal invagination was only made after she had been admitted to hospital for the third time. The following false diagnoses had been made during the 4-week course of the condition: pyelonephritis, acute appendicitis, chronic appendicitis and, most recently psychosomatic abdominal distress. The patient was initially treated with antibiotics and finally with psychotropic drugs. Eventually ultrasound suggested the diagnosis of invagination of the small intestine, which was then verified by conventional barium follow-through radiography. The patient subsequently underwent resection of a segment of the small intestine. Entero-enteric invagination is a very rare event in adults, in which a single (often malignant) cause is identified as triggering the invagination. Peristalsis and ingested food push the tumor distad, thus acting as a motor for invagination. The preferred localizations are the junctions between freely moving segments to retroperitoneally fixed segments (e.g., ileocecal region). Ultrasound of the abdomen is the examination of choice for diagnosis of enteroenteric invagination. Surgical resection of the invagination and its cause (generally tumors) is indicated in adults.相似文献
4.
探讨肠套叠二次空气灌肠的指征及其临床意义。方法:首次空气灌肠失败经选择后二次空气灌肠29例。结果:23例肠套叠经二次空气灌肠整合治愈,6例肠套叠二次空气灌肠整复失败,经手术证实4例为回回结型肠套叠,2例为回结型肠套叠。本组无1例并发肠穿孔。 相似文献
5.
247例小儿急性肠套叠的诊治体会 总被引:2,自引:0,他引:2
目的 分析小儿肠套叠的临床特点、诊断及治疗。方法 总结247例小儿急性肠套叠的临床表现、治疗及效果。结果 244例均以阵发性哭闹(或腹痛)、呕吐、血便和腹部包块为主要症状,X线透视下行空气灌肠确诊和整复治疗,成功达210例(85.3%)。结论 小儿急性肠套叠早期诊断和治疗与预后相关。 相似文献
6.
Perforation during gas reduction of intussusception 总被引:2,自引:0,他引:2
Perforation during attempted gas-enema reduction of intussusception is more common than during a barium enema. In a review
of 650 consecutive attempted gas enemas, perforation occurred in 7 infants (1.1%). Gross abdominal distension from the pneumoperitoneum
may be rapid and cause splinting of the diaphragm, which leads to acute respiratory distress. This complication is readily
recognised at the time of the gas enema, and may require immediate intervention by paracentesis using a 14-gauge needle. A
review of 7 children with intussusception in whom perforation occurred revealed that all had radiologic evidence of bowel
obstruction (air-fluid levels) prior to the enema, and the patients had had a relatively long history since the onset of symptoms.
No perforation occurred during a delayed repeat enema reduction. Perforation during gas enema produces minimal peritoneal
contamination. No pathological lesion at the lead point of the intussusception was identified in any of the children in whom
perforation occurred. 相似文献
7.
The diagnosis and treatment of idiopathic intussusception of childhood have changed over the last 10 years. Current diagnostic
techniques include plain radiographs and ultrasonography. The standard treatment in the absence of peritonitis or free intra-abdominal
air is gas enema, followed by surgical intervention if the intussusception remains irreducible. This review, by radiologists
for surgeons, describes the current role of imaging in the diagnosis and management of intussusception. 相似文献
8.
Adult intussusception secondary to inflammatory polyp occurs rarely. Imaging of intussusception on ultrasound, CT and MRI
has been previously described. In this report we describe a case of an adult intussusception secondary to inflammatory fibroid
polyp. Both the lead point (inflammatory fibroid polyp) and intussusception were depicted on multiplanar MR images. Findings
on MRI were confirmed at surgery and histopathological examination.
Received: 11 January 2000; Revised: 3 May 2000; Accepted: 4 May 2000 相似文献
9.
С����λθ�Ĥ�ϲ�����֢55���ٴ����� 总被引:1,自引:1,他引:1
目的探讨小儿异位胃黏膜症合并急腹症的临床特点。方法回顾分析了2000-12—2005-12中国医科大学第二临床学院收治的55例经病理证实存在异位胃黏膜的急腹症患儿,对其临床资料进行分类汇总和分析。结果男44例,女11例;年龄3个月至13岁,平均4·5岁。临床诊断下消化道出血31例,急性肠套叠13例,急性肠梗阻5例,急性腹膜炎6例;手术切除肠管标本经病理检查证实均有异位胃黏膜。其中Meckel憩室40例,肠重复畸形11例,肠壁正常4例。结论异位胃黏膜可能是小儿急腹症的病因之一;急腹症患儿ECT检查阴性也应开腹探查,以免遗漏异位胃黏膜。 相似文献
10.
目的探讨小儿异位胃黏膜症合并急腹症的临床特点。
方法回顾分析了2000 12—2005 12中国医科大学第二临床学院收治的55例经病理证实存在异位胃黏膜的急腹症患儿,对其临床资料进行分类汇总和分析。
结果男44例,女11例;年龄3个月至13岁,平均45岁。临床诊断下消化道出血31例,急性肠套叠13例,急性肠梗阻5例,急性腹膜炎6例;手术切除肠管标本经病理检查证实均有异位胃黏膜。其中Meckel憩室40例,肠重复畸形11例,肠壁正常4例。
结论异位胃黏膜可能是小儿急腹症的病因之一;急腹症患儿ECT检查阴性也应开腹探查,以免遗漏异位胃黏膜。 相似文献