小儿先天性肥厚性幽门狭窄合并肠旋转不良的临床特点

目的 探讨小儿先天性肥厚性幽门狭窄合并肠旋转不良的临床特点.方法 回顾性分析2003年1月至2009年12月于我科治疗的6例先天性肥厚性幽门狭窄合并肠旋转不良患儿的临床资料.结果 通过胃肠透视及超声检查,4例患儿术中确诊该病并经1次手术解决,2例术前仅诊断为先天性肥厚性幽门狭窄,行幽门肌切开术,再次出现呕吐后行2次手术发现肠旋转不良.所有病例预后良好.结论 先天性肥厚性幽门狭窄合并肠旋转不良较为少见,病因不清,先天性肥厚性幽门]狭窄的症状易掩盖肠旋转不良的临床表现而贻误其诊断.胃肠透视对于诊断该病有重要意义,彩超检查有良好的应用价值,及时的诊断治疗可获得良好的治疗效果.

Congenital hypertrophic pyloric stenosis associated with intestinal malrotation in infants:clinical characteristics

Objective To investigate the clinical characteristics and management of congenital hypertrophic pyloric stenosis (CHPS) associated with intestinal malrotation (IM) in infants.Methods The clinical data of 6 cases with CHPS and IM admitted in our hospital from Jan 2003 to Dec 2009 were reviewed,including clinical presentation,symptoms and information of imageology.Results Through barium meal examination and sonography,4 cases were diagnosed CHPS and IM,pyloromyotomy and Ladd's procedure were performed;two cases were diagnosed CHPS,only pyloromyotomy was done,secondary operation was performed for recrudescence of vomiting.All the cases were followed up for 1 to 3 years with good prognosis.Conclusion The etiology of CHPS with IM isn't clear.The diagnosis of IM may be delayed because the symptoms of IM can be masked by that of CHPS.It is helpful for diagnosis of this disease to have barium meal and sonography examination.Good prognosis will be achieved if prompt preoperative diagnosis and operation can be done.