Lee Hyun Sug, Chung Ju Young, Koo Ja Wook, Kim Sang Woo, Kim Soung Hee
Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2006 Jan;47(1):37-43.
BACKGROUND/AIMS: Small bowel intussusception is rarely diagnosed in children. And its studies have not been frequently reported. While surgical treatment has been considered as standard treatment in small bowel intussusception in adult population, spontaneous reduction of it is increasingly reported recently. Therefore, we analyzed the clinical features and outcome of small bowel intussusception in children compared with ileocolic intussusception.
95 children with the diagnosis of intussusception who visited Sanggye-Paik hospital were included in this study between March 2000 and December 2003. We retrospectively reviewed the clinical records and imaging findings. Ultrasonographic studies were performed by an experienced pediatric radiology staff using SEQUOIA 512 machine (probe 4-8 MHz).
A total of 80 patients with ileocolic intussusception (41 male, 39 female) and 15 patients (11 male, 4 female) with small bowel intussusception were diagnosed. Children with small bowel intussusception were older than ileocolic intussusception (mean age: 40 months vs. 16 months). The presenting symptoms of small bowel intussusception were vomiting, irritability, abdominal pain, bloody stool, and abdominal mass in order and were not different with those of ileocolic intussusception. While in ileocolic intussusception group, reduction was done by gastrograffin enema (73.8%), spontaneous reduction (0%) and surgical reduction (26.3%), spontaneous reduction was done in 73.3% and surgical reduction in 20% in small bowel intussusception group.
Small bowel intussusception in children occurred in older age than ileocolic intussusception and was reduced spontaneously in large proportion.
背景/目的:小儿小肠套叠很少被诊断出来,相关研究报告也不多。虽然手术治疗一直被认为是成人小肠套叠的标准治疗方法,但最近自发性复位的报道越来越多。因此,我们分析了小儿小肠套叠与回结肠套叠相比的临床特征和预后。
2000年3月至2003年12月期间,95例在祥溪白医院就诊并诊断为套叠的儿童纳入本研究。我们回顾性分析了临床记录和影像学检查结果。超声检查由经验丰富的儿科放射科工作人员使用SEQUOIA 512机器(探头4 - 8MHz)进行。
共诊断出80例回结肠套叠患儿(男41例,女39例)和15例小肠套叠患儿(男11例,女4例)。小肠套叠患儿的年龄比回结肠套叠患儿大(平均年龄:40个月对16个月)。小肠套叠的主要症状依次为呕吐、烦躁、腹痛、血便和腹部肿块,与回结肠套叠的症状无差异。回结肠套叠组中,通过泛影葡胺灌肠复位的占73.8%,自发性复位的占0%,手术复位的占26.3%;小肠套叠组中,73.3%为自发性复位,20%为手术复位。
小儿小肠套叠的发病年龄比回结肠套叠大,且大部分可自发性复位。