超声诊断小儿肠旋转不良

摘要

Objective To assess the possibility of diagnosing intestinal malrotation in children by altrasonography.Methods Nine of 28 cases of intestinal malrolation were predicted by uhrasonography whereas other 19 cases were followed up postoperatively.Results Six of 7 eases of malrotation were showed on the abnormal position of superior mesenteric vessd and diagnosd malrotation.Ultrasonography showed"whirlpool sign"(indicating volvulus) in 5 0f 6 cases.Two cases of intestinal malrotation were diagnosed by ultrasonography and confirmed by gastro-intesenal radicgraphy later(without operation).17 of 19 eases followed up were showed the superior mesenteric vein was located tO the left side or in front of the superior mesenterie artery(abnormal position,89%).Only 2 patients were showed on the right side(normal position).Conclusions Detecting of the relative position of the superior mesenteric vessels by ultrasonography is a important step to diagnose the intestinal malrotion.When the superior mesenteric vein is located to left of the superior mesenterie artery.the malrotation should he diagnosed and be suspect when the vein is in front of artery.Volvutus should be confirmed as being presented"whirlpool sign".%目的 探讨彩色及二维超声诊断小儿肠旋转不良及肠扭转的可能性.方法 28例肠旋转不良患儿,9例为前瞻性探测(7例手术证实),19例为肠旋转不良术后随访.结果 7例肠旋转不良术前超声显示:6例肠系膜上血管关系异常,诊断为肠旋转不良,其中5例超声发现"漩涡征"诊断合并肠扭转(手术证实6例合并肠扭转).2例超声发现肠系膜上血管关系异常,后经消化道造影证实肠旋转不良(未手术).超声随访19例肠旋转不良术后患儿,17例(89%)肠系膜上静脉位于肠系膜上动脉的左侧或前方,2例位于右侧,即正常关系.结论 超声探测肠系膜上血管的位置及关系对诊断肠旋转不良有重要价值,如果发现肠系膜上静脉位于肠系膜上动脉左侧,可诊断肠旋转不良,位于前方者应怀疑本症.一旦测及"漩涡征",应诊断肠扭转.