Görgen-Pauly U, Schultz C, Kohl M, Sigge W, Möller J, Gortner L
Department of Paediatric Surgery, Medical University of Lübeck, Lübeck, Germany.
Eur J Pediatr. 1999 Oct;158(10):830-2. doi: 10.1007/s004310051216.
Intussusception is an extremely rare disorder in preterm infants. An infant of 29 weeks gestational age with this condition is reported and a retrospective analysis of 17 previously reported cases presented. In the reviewed preterm infants, risk factors for intussusception seemed to be multifactorial. Clinical features included severe abdominal distension (17/17), gastric aspirates (13/17), commonly bilious, bloody stools (10/17) and rarely a palpable abdominal mass (5/17). Diagnostic features were signs of small bowel obstruction on the abdominal radiographs. Signs and symptoms were similar to those seen in necrotizing enterocolitis, therefore difficulties in establishing a correct diagnosis led to an average delay of 7 days between the onset of symptoms and abdominal surgery, increasing the risk of developing a compromised bowel.
The differential diagnosis of an intussusception should be considered in preterm infants with acute abdominal distension and tenderness.
肠套叠在早产儿中是一种极其罕见的病症。本文报道了一名孕29周患有此病的婴儿,并对之前报道的17例病例进行了回顾性分析。在所回顾的早产儿中,肠套叠的危险因素似乎是多因素的。临床特征包括严重腹胀(17/17)、胃抽出物(13/17),通常为胆汁样、血性大便(10/17),很少能触及腹部肿块(5/17)。诊断特征为腹部X光片上显示小肠梗阻的迹象。体征和症状与坏死性小肠结肠炎所见相似,因此难以做出正确诊断导致症状出现至腹部手术之间平均延迟7天,增加了肠功能受损的风险。
对于出现急性腹胀和压痛的早产儿,应考虑肠套叠的鉴别诊断。