Coşkun Abdulhakim, Sevinç Halil
Erciyes Universitesi Tip Fakültesi, Radyoloji Anabilim Dali, Kayseri, Turkey.
Tani Girisim Radyol. 2004 Mar;10(1):78-86.
A wide spectrum of congenital anomalies may cause obstruction in the upper and lower gastrointestinal tract. Neonates with complete upper intestinal obstruction do not usually require further radiological evaluation after radiography. Barium studies are sometimes needed. Barium studies and other comprehensive methods such as ultrasonography, computed tomography and magnetic resonance imaging are usually complementary procedures which are not usually helpful and may even delay surgery, resulting in some complications and death. The decision to perform a given imaging examination should be considered carefully to avoid unnecessary radiation exposure to the patient. The diagnosis of low intestinal obstruction is usually apparent at abdominal radiography because of the presence of many dilated loops. The differentiation between ileal and colonic obstruction can be made with a contrast enema study. Dilute ionic, water-soluble contrast agents and non-balloon tip catheter of appropriate size is preferred for neonatal contrast enemas. Barium sulphate suspensions typically should not be used because of their potential to exacerbate the impaction of meconium plugs in meconium ileus, whereas water-soluble enemas can be therapeutic.
多种先天性异常可导致上、下胃肠道梗阻。患有完全性上肠梗阻的新生儿在进行X线摄影后通常不需要进一步的放射学评估。有时需要进行钡剂检查。钡剂检查以及超声、计算机断层扫描和磁共振成像等其他综合方法通常是互补的程序，但通常并无帮助，甚至可能延误手术，导致一些并发症和死亡。决定进行特定的影像学检查时应谨慎考虑，以避免患者受到不必要的辐射暴露。由于存在许多扩张的肠袢，低位肠梗阻的诊断在腹部X线摄影时通常很明显。回肠梗阻和结肠梗阻的鉴别可以通过灌肠造影检查来进行。新生儿灌肠造影首选稀释的离子型水溶性造影剂和合适尺寸的无球囊头导管。硫酸钡混悬液通常不应使用，因为它们可能会加重胎粪性肠梗阻中胎粪栓的嵌塞，而水溶性灌肠剂则具有治疗作用。
