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[肠套叠:21世纪能否轻松诊断?五年经验的结果]

[Intestinal intussusception: easy diagnosis in the 21st Century? Outcome of five years experiences].

作者信息

Leva E, Cardarelli M, Di Cesare A, Fava G, Venegoni A, Stringhi C, Maestri L, Zoia E, Pansini L

机构信息

Ospedale dei Bambini V. Buzzi, ICP Milano, Divisione di Chirurgia Pediatrica.

出版信息

Pediatr Med Chir. 2005 Nov-Dec;27(6):38-40.

Abstract

UNLABELLED

Intussusception is an entity well codify in pediatric surgery, with guidelines well defined since years in terms of imaging and procedures.

MATERIAL

From January '99 to Dec. '03, 25 children were admitted to the Department of Pediatric Surgery of the Children's Hospital of Milan. All the aspects related to the pathology have been evaluated in the study.

RESULTS

25 patients have been studied. 23/25 presented severe pain, 19/25 normal bowel movements in the last 3 hours and in 9/25 a mass were detected at clinical examination.19/25 were submitted to laparotomy after failure of reduction through barium enema, and in 17/19 a manual reduction were performed. Only 2 patients required a bowel resection with primary anastomosis. The analysis of the delay of diagnosis, the delta-T between beginning of the symptoms and first medical evaluation was of 16,23 h. (3-72), and the delta-T between the first evaluation and diagnosis was 18,7 h. The interval between diagnosis and surgery was of 4,3.

CONCLUSION

Authors believe that intussusception still represent a challenge for medical and surgical emergency team, supported by the data in literature. Imaging procedures must not be constricted in case of minimal suspicions of intestinal intussusception.

摘要

未标注

肠套叠是小儿外科中一种已被充分编码的病症,多年来在影像学和手术方面都有明确的指南。

材料

1999年1月至2003年12月,25名儿童被收治于米兰儿童医院小儿外科。本研究评估了与该病症相关的所有方面。

结果

对25例患者进行了研究。25例中有23例出现剧痛,25例中有19例在过去3小时内排便正常,临床检查发现25例中有9例触及肿块。19例经钡剂灌肠复位失败后接受了剖腹手术,其中19例中有17例进行了手法复位。仅2例患者需要行肠切除并一期吻合术。对诊断延迟进行分析,症状开始至首次医学评估的时间间隔(δ-T)为16.23小时(3 - 72小时),首次评估至诊断的δ-T为18.7小时。诊断至手术的间隔时间为4.3小时。

结论

作者认为,根据文献数据,肠套叠对医疗和外科急救团队而言仍是一项挑战。在对肠套叠有最小怀疑时,影像学检查程序不应受限。

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