Mcheik J N, Levard G
Service de chirurgie pédiatrique, centre hospitalo-universitaire de Poitiers, 350, avenue Jacques-Coeur, BP 577, 86021 cedex, Poitiers, France.
Arch Pediatr. 2003 Mar;10(3):230-1. doi: 10.1016/s0929-693x(03)00327-0.
A case of intrauterine intussusception causing ileal atresia is reported. The neonate presented at the age of one day with bilious vomiting, failure to pass meconium and progressive abdominal distension. A clinical diagnosis of intestinal obstruction was made, and was confirmed by plain abdominal radiographs. At laparotomy, atresia of the terminal ileum was found. The lumen of the resected distal segment contained an intussusceptum. The blind ends were resected and an anastomosis was performed. Recovery was uneventful.
Intrauterine bowel intussusception is a rare clinical entity. When intussusception occurs in the foetus and the time elapsed is enough to allow for gangrene and resorption of the intussuscepted portions of the bowel, intestinal atresia may result.
The careful examination of the distal blind end of the ileum aids to obtain a correct classification and etiologic diagnosis of the atresia.
本文报告一例宫内肠套叠导致回肠闭锁的病例。该新生儿出生一天时出现胆汁性呕吐、未排胎便及进行性腹胀。临床诊断为肠梗阻,腹部平片证实了这一诊断。剖腹探查时,发现末端回肠闭锁。切除的远端肠段腔内含有一个肠套叠。切除盲端并进行吻合。恢复过程顺利。
宫内肠套叠是一种罕见的临床病症。当胎儿发生肠套叠且经过的时间足以导致肠套叠部分肠管坏疽和吸收时,可能会导致肠闭锁。
仔细检查回肠远端盲端有助于对闭锁进行正确的分类和病因诊断。