儿童梅克尔憩室索带继发急性肠梗阻超声表现

目的 观察儿童梅克尔憩室(MD)索带继发急性肠梗阻超声表现。方法 回顾性分析12例MD索带继发急性肠梗阻患儿,观察其临床、超声表现及手术所见。结果 12例中,术前超声初诊仅检出1例扩张MD、漏诊11例,复诊发现其中5例存在空瘪MD、6例仍未能检出;12例均见不同程度肠扩张、肠壁增厚及腹腔积液,肠扩张表现为低位肠梗阻,梗阻点位于脐部-右下腹;8例因探及索带与邻近肠结构形成的“十字交叉征”而准确诊断腹内疝。术中见9例MD与肠系膜间索带、2例MD与肠壁间索带、1例MD与腹壁间索带,均不同程度压迫回肠引发低位肠梗阻。结论 儿童MD索带继发急性肠梗阻的梗阻点多位于脐部-右下腹,常合并肠壁增厚和腹腔积液。

Ultrasonic manifestations of acute intestinal obstruction secondary to band attached to Meckel's diverticulum in children

Objective To observe the ultrasonic manifestations of acute intestinal obstruction secondary to band attached to Meckel''s diverticulum (MD) in children. Methods Data of 12 children with acute intestinal obstruction secondary to band attached to MD were retrospectively analyzed, the clinical characteristics, ultrasound manifestations and surgical findings were observed. Results In 12 cases, only 1 case of dilated MD was detected with initial ultrasound before surgery, and the remaining 11 cases were missed. Among 11 cases of missed by initial ultrasound, reviewing physicians detected empty MD in 5 cases, while the remaining 6 cases were still undetected. On initial ultrasound, different degrees of intestinal dilatation, intestinal wall thickening and abdominal fluid were observed in all 12 cases, with intestinal dilation manifested as low intestinal obstruction, and the obstruction point located in the umbilical cord-right lower abdomen. Initial ultrasound displayed "cross sign" of the bands with adjacent intestinal structures and accurately diagnosed internal abdominal hernia in 8 cases. During surgical operations, bands connect wall of MD to mesentery were found in 9 cases, to adjacent intestinal wall in 2 cases, to abdominal wall in 1 case, all compressed ilea in various degrees causing secondary low intestinal obstruction. Conclusion The obstruction point of acute intestinal obstruction secondary to band attached to MD in children often located in the umbilical cord-right lower abdomen, complicated with intestinal wall thickening and abdominal fluid.