Slam Kristine D, Teitelbaum Daniel H
Department of Surgery, University of Toledo, Health Science Campus, Toledo, Ohio, USA.
J Pediatr Surg. 2007 Jul;42(7):1279-81. doi: 10.1016/j.jpedsurg.2007.02.028.
We present a case of multiple sequential intussusceptions in a preterm neonate that resulted in mechanical bowel obstruction. The differential diagnosis of abdominal obstruction in a neonate is extensive, requiring a thorough review of presentation and methodical workup to determine etiology (Teitelbaum DH. Obturation obstruction of the intestine. In: O'Neill JA, editor. Principles of pediatric surgery. St. Louis (MO): Mosby, 2003. p. 605-612). Rare causes must be considered in a patient with no obvious etiology on contrast studies and persistent symptoms. Intussusception, a common cause of obstruction and pain in older infants and children, can rarely occur in neonates and is unfortunately difficult to diagnose preoperatively (J Pediatr. 1955;47:87-94; Pediatr Surg Int. 1998;13:232-236; Ann Saudi Med. 2000; 20:310-312; Eur J Pediatr. 1999;158:830-832; J Paedatr Child Health. 2004;40:388-391; Radiology. 1977;125:463-466; J Perinat Med. 2004;32:190-194).
我们报告一例早产新生儿发生多次连续性肠套叠，导致机械性肠梗阻。新生儿腹部梗阻的鉴别诊断范围广泛，需要全面回顾临床表现并进行系统检查以确定病因（泰特尔鲍姆DH。肠道闭塞性梗阻。见：奥尼尔JA主编。小儿外科学原理。密苏里州圣路易斯：莫斯比出版社，2003年。第605 - 612页）。对于造影检查无明显病因且症状持续的患者，必须考虑罕见病因。肠套叠是较大婴儿和儿童肠梗阻及疼痛的常见原因，在新生儿中很少发生，且不幸的是术前难以诊断（《儿科学杂志》。1955年；47:87 - 94；《小儿外科国际》。1998年；13:232 - 236；《沙特医学杂志》。2000年；20:310 - 312；《欧洲儿科学杂志》。1999年；158:830 - 832；《儿科与儿童健康杂志》。2004年；40:388 - 391；《放射学》。1977年；125:463 - 466；《围产医学杂志》。2004年；32:190 - 194）。
