摘要
目的 观察儿童腹内疝超声表现及年龄分布.方法 回顾性分析53例经手术证实的腹内疝患儿,观察其超声表现及年龄分布.结果53例中,术前超声显示22例(22/53,41.51％)存在"十字交叉征"、26例(26/53,49.06％)可见"疝环鸟嘴征",据此诊断21例腹内疝,准确率为39.62％(21/53);48例(48/53,90.57％)见肠梗阻表现;22例(22/53,41.51％)考虑为肠坏死;误诊4例,误为肠穿孔、阑尾炎、肠闭锁及肠扭转各1例.53例患儿中,术后粘连索带内疝发病年龄高于肠系膜裂孔疝(P＜0.05),其余各型腹内疝发病年龄差异无统计学意义(P均＞0.05);术中发现25例肠缺血坏死,≤1岁、＞1且≤3岁、＞3且≤7岁及＞7岁腹内疝患儿肠坏死发生率分别为66.67％(12/18)、33.33％(4/12)、36.36％(4/11)及41.67％(5/12).结论 儿童腹内疝特征性超声表现包括"十字交叉征"及"疝环鸟嘴征";1岁以下患儿肠坏死发生率较高.
Abstract
Objective To observe the ultrasonic manifestations and age distribution of internal abdominal hernia in children.Methods Data of 53 children with internal abdominal hernia confirmed by operation were retrospectively analyzed.The ultrasonic findings were observed,and the age distribution of children was analyzed.Results Among 53 cases,"cross sign"was observed in 22 cases(22/53,41.51％),and"hernia ring beak sign"was detected in 26 cases(26/53,49.06％)by preoperative ultrasound,according to which 21 cases were diagnosed as internal abdominal hernia,with the accuracy of 39.62％(21/53).Meanwhile,manifestations of intestinal obstruction were noticed in 48 cases(48/53,90.57％),and intestinal necrosis was considered in 22 cases(22/53,41.51％).Four cases were misdiagnosed as intestinal perforation,appendicitis,intestinal atresia and volvulus,each in 1 case.The onset age of postoperative adhesive band internal hernia was larger than that of mesenteric hiatal hernia(P＜0.05),while no significant difference of onset age was found among other types of internal abdominal hernias(all P＞0.05).Intestinal ischemic necrosis was found in 25 cases,while the incidence of intestinal necrosis in children aged ≤1 year,＞1 and ≤3 years,＞3 and ≤7 years and those＞7 years was 66.67％(12/18),33.33％(4/12),36.36％(4/11)and 41.67％(5/12),respectively.Conclusion The characteristic ultrasonic findings of internal abdominal hernia in children included"cross sign"and"hernia ring beak sign".Internal abdominal hernia in children under 1 year had high risk of intestinal necrosis.
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