Lai P C, Jehng C H, Chiang L M, Liao K S, Chen M H, Ho M M, Hwang K C
Department of Pediatrics, Taiwan Provincial Tao-Yuan General Hospital, R.O.C.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1991 Jan-Feb;32(1):47-53.
A case of jejunal atresia with "apple peel" deformity is presented. A 27-year-old woman, gravida 3, para 2, suffered from premature labor pain and vaginal bleeding at 32 weeks of gestation. Prenatal ultrasound examination revealed presence of three areas of cystic dilatation in the fetal abdomen and marked polyhydramnios, indicating a high bowel obstruction. A female baby was delivered by Cesarean section with Apgar scores of 7 and 8 at one and five minutes, respectively. Physical examination showed abdominal distention. Nasogastric tube aspiration got more than 50 ml of blood-tinged fluid. Roentgenography demonstrated a high jejunal obstruction as well as a normally rotated colon. Laparotomy disclosed proximal jejunal atresia with typical "apple peel" appearance of the distal small bowel. An end-to-end anastomosis was performed smoothly after resection of both the proximal and distal small bowels. A reduction tapering antimesenteric jejunoplasty was also done. Partial parenteral nutrition had been administered for 10 days followed by enteric feeding. The postoperative course was uneventful. Her chromosomal analysis revealed a normal karyotype of 46,XX.
本文报告一例伴有“苹果皮”畸形的空肠闭锁病例。一名27岁女性，孕3产2，在妊娠32周时出现早产疼痛和阴道出血。产前超声检查显示胎儿腹部有三个囊性扩张区域，羊水过多，提示高位肠梗阻。一名女婴通过剖宫产分娩，1分钟和5分钟时的阿氏评分分别为7分和8分。体格检查显示腹胀。鼻胃管抽出超过50毫升血性液体。X线检查显示高位空肠梗阻以及正常旋转的结肠。剖腹手术发现近端空肠闭锁，远端小肠呈典型的“苹果皮”外观。切除近端和远端小肠后顺利进行了端端吻合。还进行了减容锥形系膜对侧空肠成形术。术后给予肠外营养10天，随后开始肠内喂养。术后过程顺利。她的染色体分析显示核型正常，为46,XX。
