Necas Martin, Thomas Stacey, Prout Kara
Ultrasound Department Waikato Hospital Hamilton New Zealand.
Australas J Ultrasound Med. 2023 Jun 21;26(3):191-198. doi: 10.1002/ajum.12352. eCollection 2023 Aug.
Intussusception is typically considered an acute emergency; however, the increased utilisation of medical imaging has revealed that intussusceptions can also be transient, asymptomatic and possibly physiologic. Sonographers should be aware of three categories of intussusceptions: (i) persistent intussusceptions resulting in acute abdomen and requiring urgent intervention, (ii) transient symptomatic intussusceptions which may be amenable to a 'wait-and-see' strategy and (iii) transient asymptomatic intussusceptions which almost always involve the small bowel. In particular, the incidental discovery of enteroenteric intussusceptions in children should not be confused with acute pathology. In adults, sonographers should be mindful of the frequent presence of pathological lead points and further investigations may be warranted. In this literature review, we provide an overview of transient intussusceptions, highlight important differences between children and adults and describe sonographic appearances of various intussusceptions and their mimics.
肠套叠通常被视为一种急性急症;然而,医学成像技术的更多应用显示,肠套叠也可能是短暂的、无症状的,甚至可能是生理性的。超声检查人员应了解三类肠套叠:(i)导致急腹症并需要紧急干预的持续性肠套叠,(ii)可能适合“观察等待”策略的短暂性症状性肠套叠,以及(iii)几乎总是累及小肠的短暂性无症状肠套叠。特别是,儿童偶然发现的小肠-小肠型肠套叠不应与急性病变相混淆。对于成人,超声检查人员应留意经常存在的病理性引导点,可能需要进一步检查。在这篇文献综述中,我们概述了短暂性肠套叠,强调儿童和成人之间的重要差异,并描述了各种肠套叠及其相似病变的超声表现。