新生儿消化道穿孔的X线诊断(附15例分析)

The X-ray Diagnosis of Newborn Alimentary Tract Perforation (An Analysis of 15 Cases)

目的:提高对新生儿消化道穿孔的X线诊断水平。方法:搜集整理经手术病理证实的新生儿消化道穿孔15例,男12例,女3例。其中胃穿孔12例,小肠穿孔2例,结肠穿孔1例。分析不同部位、不同原因的穿孔特点及其X线表现。结果:15例消化道穿孔X线诊断14例。X线表现:胃穿孔气腹量较多,腹脂肪线均消失,腹部气液平面较大,胃泡明显消失或变小;小肠及结肠穿孔表现气腹量少;先天性胃壁肌缺如引起的消化道穿孔发病早,穿孔大且气腹量多;胃溃疡引起的穿孔一般较小,常继发于严重缺氧或严重感染,气腹量较前者少。结论:不同部位、不同原因的穿孔各有特点,不同体位的X线平片检查是新生儿消化道穿孔诊断的首选方法。

Objective;To improve the X-ray diagnostic capability and knowledge of newborn alimentary tract perforation, Methods.. Among 15 cases of newborn alimentary tract perforation confirmated by surgical operation and pathology, 12 cases were stomach perforation,2 cases were small intestine and 1 case was colon. 12 cases were males and 3 cases were females, The sufferer age：8 hours-30 days after birth （average 7 days）. Perforation characteristics and X-ray performances related to the different sites and various causes were analyzed. Results.. Of the 15 cases, 14 cases were diagnosed by routine roentgenographic examination. X-ray exhibition.. Perforation of stomach showed pneumoperitoneun, plenty gas in the peritoneum cavity,and the stomach gas bulb being diminished or disappeared;but only small amount of gas was seen in the perforation of small intestine and colon. In the case of congenital absence of stomach muscle, the perforation site was big,and the amount of gas leak to the peritoneum cavity was plenty. Conclusion., Newborn alimentary tract perforation of different sites and various causes have characteristics and X ray exhibitions respectively. Various positions to take X-ray film is a successful method for diagnosis.