Wayne E R, Campbell J B, Kosloske A M, Burrington J D
J Pediatr Surg. 1976 Oct;11(5):789-94. doi: 10.1016/0022-3468(76)90104-4.
Examination of the records of 378 children with intussusception at our institution revealed that 29 cases were caused by an identifiable intestinal lesion. A Meckel's diverticulum was the causative agent in 21 children, all of whom were under 2 yr of age. A previously undiagnosed ileal lymphosarcoma produced the intussusception in six other children, all between 6 1/2 and 9 yr of age. Our experience indicates that any child over 6 yr of age with the clinical findings of colicky abdominal pain, bloody stools, and a palpable mass plus the radiographic evidence of intussusception must be considered to have ileal lymphosarcoma until proven otherwise. Hydrostatic reduction of the intussusception must be accompanied by extensive small bowel reflux of barium in order to effectively rule out a small intestinal lesion. If this is not accomplished, surgery should be planned with the suspicion that a malignancy may be present. If this suspicion is confirmed by frozen section, the operation procedure should include wide surgical excision of the lesion along with the regional lymph nodes.
对我院378例肠套叠患儿的记录进行检查后发现，29例是由可识别的肠道病变引起的。梅克尔憩室是21例患儿的病因，所有这些患儿均在2岁以下。另外6例患儿的肠套叠是由先前未诊断出的回肠淋巴肉瘤引起的，这些患儿年龄均在6.5岁至9岁之间。我们的经验表明，任何6岁以上具有绞痛性腹痛、血便、可触及肿块的临床表现以及肠套叠影像学证据的患儿，在未得到其他证明之前，都必须被视为患有回肠淋巴肉瘤。肠套叠的水压复位必须伴有钡剂在小肠的广泛反流，以便有效地排除小肠病变。如果做不到这一点，应在怀疑可能存在恶性肿瘤的情况下计划手术。如果冰冻切片证实了这种怀疑，手术程序应包括对病变连同区域淋巴结进行广泛的手术切除。
