儿章肠旋转不良的X线诊断

目的：总结肠旋转不良的X线征象,评价各种检查方法的诊断价值。方法：回顾性分析40例肠旋转不良的X线表现,腹部平片及上消化道钡餐40例,钡灌肠20例。结果：腹部平片发现上消化道梗阻34例,其中4例见空肠异佐征;上消化道钡餐发现十二指肠梗阻37例,屈氏韧带位置异常21例,螺纹征16例;钡灌肠发现盲肠位置异常15例(15/20)。结论：屈氏韧带位置异常、螺纹征及盲肠异性是肠旋转不良的特异性征象;三种X线检查方法结合应用有利于提高肠旋转不良的检出率。

X-ray diagnosis of intestinal malrotation in children

Objective:To sum up the x- ray signs of intestinal malrotation and to evaluate the means of examination. Methods:40 cases of intestinal malrotation in children aged from 1 hour to 16 years were reviewed. The diagnostic evaluations included 40 plain abdomen films,40 upper gastrointestinal barium series and 20 barium enemas. Results: Upper gastrointestinal obstruction was found on the plain film in 34 cases among which 4 showed abnormal position of jejunum. Duodenal obstruction was detected in 37 cases with gastrointestinal barium study among which 21 showed malposition of duodenojejunal junction and 16 showed "whorl" sing. Fifteen of twenty were found abnamal cecal position with barium enema examination. Conclusion :The malposition of duodenojejunal junction, "whorl" sign and abnormal cecal position are special signs of intestinal malrotation;The combination of the three x- ray examinations may be helpful in the diagnosis of intestinal malrotation.