Riis A, Pedersen S A
Odense Sygehus, Kirurgisk gastroenterologisk afdeling K.
Ugeskr Laeger. 1992 Jan 20;154(4):194-8.
During 13 years, 47 infants were treated for mechanical ileus resulting from intestinal obstruction located proximally to the coecum (duodenal obstruction, malrotation, jejuno-ileal obstruction and meconium ileus). The mortality and morbidity were low. A total of three infants died; all of them in the immediate postoperative period. One infant died on account of rupture of the anastomosis; in two infants, death was caused by pulmonary complications and disseminated intravasal coagulation. Seven reoperations were performed and among these five infants on account of adhesions-/fibrous band ileus. At follow-up examination five infants were slightly underweight and retarded in growth; only one child had troublesome gastrointestinal problems. We recommend the use of antenatal ultrasound in the 30th week of gestation more frequently and always when polyhydramnios is present. This should raise the suspicion of gastrointestinal obstruction. Postnatal screening for associated congenital anomalies should also be done, since these are the most frequent cause of death in this patient category.
在13年期间，47例因盲肠近端肠梗阻（十二指肠梗阻、肠旋转不良、空回肠梗阻和胎粪性肠梗阻）导致机械性肠梗阻的婴儿接受了治疗。死亡率和发病率较低。共有3例婴儿死亡；均在术后即刻死亡。1例婴儿死于吻合口破裂；2例婴儿死于肺部并发症和弥散性血管内凝血。进行了7次再次手术，其中5例婴儿是由于粘连性/纤维带性肠梗阻。随访检查时，5例婴儿体重略低于正常且生长发育迟缓；只有1名儿童有令人困扰的胃肠道问题。我们建议在妊娠第30周更频繁地使用产前超声检查，并且当出现羊水过多时总是进行检查。这应能提高对胃肠道梗阻的怀疑。还应进行产后相关先天性异常的筛查，因为这些是该类患者最常见的死亡原因。
