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原发性肠套叠手术患儿术后发生的肠套叠——一种非常罕见的情况。

Postoperative intussusception in children operated for primary intussusception - A very rare entity.

作者信息

Chaudhary Muhammad Amjad, Jamil Aisha, Burki Sadia Asmat

机构信息

Muhammad Amjad Chaudhary, MS Pediatric Surgery, FRCS, FRCS, Department of Neonatal and Pediatric Surgery, The Children Hospital, Pakistan Institute of Medical Sciences, SZAB Medical University, Islamabad, Pakistan.

Chandni,, Department of Neonatal and Pediatric Surgery, The Children Hospital, Pakistan Institute of Medical Sciences, SZAB Medical University, Islamabad, Pakistan.

出版信息

Pak J Med Sci. 2024 May-Jun;40(5):1035-1038. doi: 10.12669/pjms.40.5.8276.

Abstract

Postoperative intussusception (POI) after abdominal and non-abdominal operations is a rare but recognized condition discussed several times in literature. There are scarce reports regarding POI in children operated primarily for intussusception. We discuss three such cases that were seen in our institution in the last two years. The patients showed symptoms of atypical ileus that failed to resolve two to eight days following primary surgery. Ultrasound reported intussusception and surgical intervention was sought. All patients had ileoileal intussusception. Manual reduction was successful in two cases. One had intestinal necrosis and underwent resection and anastomosis. Recovery was satisfactory without recurrence. POI should be suspected in patients who show signs of intestinal obstruction in early postoperative period. A second POI should be kept in mind after surgical reduction of the first intussusception. Ultrasound should be performed to aid diagnosis followed by urgent surgical intervention.

摘要

腹部手术和非腹部手术后的术后肠套叠(POI)是一种罕见但已被认识的病症,文献中曾多次讨论过。关于主要因肠套叠接受手术的儿童发生POI的报道很少。我们讨论过去两年在我们机构见到的三例此类病例。这些患者表现出非典型肠梗阻症状,在初次手术后两到八天仍未缓解。超声检查报告为肠套叠,于是寻求手术干预。所有患者均为回肠-回肠型肠套叠。两例手动复位成功。一例发生肠坏死,接受了切除吻合术。恢复情况良好,无复发。术后早期出现肠梗阻迹象的患者应怀疑发生POI。首次肠套叠手术复位后应警惕再次发生POI。应进行超声检查以辅助诊断,随后进行紧急手术干预。

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本文引用的文献

1
Ultrasound guided hydrostatic enema reduction of ileocolic intussusception: a safe and effective technique.
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Postoperative intussusceptions in children and infants: a systematic review.
Pediatr Surg Int. 2013 Dec;29(12):1273-9. doi: 10.1007/s00383-013-3345-1. Epub 2013 Jul 13.
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Pediatric postoperative intussusception in the minimally invasive surgery era: a 13-year, single center experience.
J Am Coll Surg. 2013 Jun;216(6):1089-93. doi: 10.1016/j.jamcollsurg.2013.01.059. Epub 2013 Apr 6.

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