先天性肠闭锁的X线诊断价值

目的:探讨X线检查在先天性肠闭锁的诊断价值,提高对本病的认识。方法:搜集经手术病理证实的先天性肠闭锁42例,术前均行腹部立位平片检查,其中12例经胃管行胃及小肠碘水造影,18例行碘水灌肠检查。结果:42例中,十二指肠闭锁6例,空肠闭锁14例,回肠闭锁19例,结肠闭锁3例,腹平片可显示不同平面的肠梗阻征象。12例胃肠造影中,显示肠闭锁盲端8例,盲端未显示4例。18例灌肠造影显示为细小结肠16例(显示结肠闭锁盲端3例),正常结肠2例。结论:腹部立位平片是先天性肠闭锁的首选导向检查方法。灌肠检查对其定位、定性及鉴别诊断是十分必要的,碘水胃肠造影检查应慎重。

X-ray diagnostic value of congenital intestinal atresia

Objective: To evaluate the X-ray appearances of congenital intestinal atresia(CIA) and to improve the understanding of this disease. Methods: Forty-two cases of CIA proved by pathology were included in the study. Before operation, erect abdominal plain radiograph were performed in all cases, iodinated aqueous contrast medium opacification through gastric canal in 12 cases, iodinated aqueous contrast solution enema in 18 cases. Results: There were 6 cases of duodenal atresia, 14 cases of jejunal atresia, 19 cases of ileal atresia and 3 cases of colon atresia in 42 cases of CIA. The X-ray plain film of abdomen can demonstrate intestinal obstruction of different levels. In 12 cases of gastroenterography, 8 cases showed the atresic caecum. In 18 cases of iodinated aqueous medium enteroclysis opacification, 16 cases demonstrated micro-colons(3 cases showed the caecum of colon atresia), two cases were normal. Conclusion: The erect abdominal plain radiograph is the best examination method of CIA. Enema is very necessary for differential diagnosis, location and nature of CIA. iodinated aqueous medium opacification through gastric canal should be used carefully.