Devane S P, Coombes R, Smith V V, Bisset W M, Booth I W, Lake B D, Milla P J
Institute of Child Health, University of London.
Arch Dis Child. 1992 Feb;67(2):218-21. doi: 10.1136/adc.67.2.218.
Persistent vomiting, diarrhoea, or intolerance of feeding, are well recognised problems in children after surgical correction of intestinal malrotation. Conversely, intestinal malrotation is a common accompaniment of chronic idiopathic intestinal pseudo-obstruction. We investigated motor activity of the small intestine during fasting in eight children who had persistent vomiting, intolerance of full enteral feeding, or severe diarrhoea after surgical correction of intestinal malrotation. Abnormality of motor function similar to that found in neuropathic pseudo-obstruction was found in seven of the eight patients. Persistence of symptoms after surgical correction of a malrotation is associated with a motility disturbance which seems to be due to a defect of intrinsic enteric innervation. Such a defect may be important in the aetiology of the malrotation.
持续性呕吐、腹泻或喂养不耐受,是小儿肠旋转不良手术矫正后公认的问题。相反,肠旋转不良是慢性特发性肠假性梗阻的常见伴随症状。我们研究了8名肠旋转不良手术矫正后出现持续性呕吐、完全肠内喂养不耐受或严重腹泻的儿童在禁食期间小肠的运动活性。8名患者中有7名发现了与神经性假性梗阻类似的运动功能异常。肠旋转不良手术矫正后症状持续存在与动力障碍有关,这种动力障碍似乎是由于肠道内在神经支配缺陷所致。这种缺陷可能在肠旋转不良的病因学中起重要作用。