Baracchini A, Chiaravalloti G, Quinti S, Rossi A, Favili T, Ughi C, Ceccarelli M
Istituto di Clinica Pediatrica, Università degli Studi, Pisa.
Minerva Pediatr. 1995 Jun;47(6):215-9.
Enteric intussusception is one f the most frequent causes of acute abdomen in early childhood, with an incidence of 1.3-2/1000 children born and higher frequency from the third to the twelfth month. Primary intussusception is related to predisponsing factors such as peristalsis disorders or Peyer's patch hypertrophy induced by viral infection. Secondary intussusception is due to organic injury in the intestinal wall. The most involved sites are the terminal ileum and the ileocecum, the most frequent type is ileocolic intussusception. Many clinical forms exist, including acute enteric intussusception with its pathognomonic triad intermittent abdominal pain, emesis and rectal bleeding and the atypical form with a neurological presentation, where sopor, myosis and muscular atonicity are dominating, Intussusception can also present in a subacute or chronic form with a slow and apsecific onset. In a retrospective investigation we examined 30 cases of intussusception in children hospitalized at the Pediatric Clinic of Pisa from the 1960s up to today. Our patients (16 males and 14 females) were aged between one month and two years. Clinical presentations resulted in; typical forms (60%), atypical forms (16%), subacute forms 13%) and recurrent forms (10%). Clinical suspicion was confirmed either by the presence of blood observed during rectal exploration, which is a pathognomonic sign, or by the opaque enema which led to recovery by means of hydrostatic reduction in 40% of the cases. The remaining patients (60%) underwent surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
小儿肠套叠是幼儿急腹症最常见的病因之一,发病率为1.3 - 2/1000活产儿,在出生后第三个月至第十二个月发病率更高。原发性肠套叠与蠕动障碍或病毒感染引起的派氏集合淋巴结肥大等易感因素有关。继发性肠套叠是由于肠壁器质性损伤所致。最常受累的部位是回肠末端和回盲部,最常见的类型是回结肠型肠套叠。存在多种临床类型,包括具有典型三联征(间歇性腹痛、呕吐和直肠出血)的急性肠套叠以及以神经症状为主的非典型形式,其中昏睡、瞳孔缩小和肌肉张力减退较为突出。肠套叠也可呈亚急性或慢性形式,起病缓慢且不具特异性。在一项回顾性研究中,我们检查了自20世纪60年代至今在比萨儿科诊所住院的30例儿童肠套叠病例。我们的患者(16名男性和14名女性)年龄在1个月至2岁之间。临床表现为:典型形式(60%)、非典型形式(16%)、亚急性形式(13%)和复发性形式(10%)。临床怀疑通过直肠检查时发现血液(这是一个典型体征)或通过钡剂灌肠得以证实,40%的病例通过水压复位得以恢复。其余患者(60%)接受了手术治疗。(摘要截选至250字)