先天性巨结肠新生儿期手术病例的影像学表现

The roentgenographic manifestations of Hirschsprung's disease surgically treated in neonate

目的:研究新生儿期HD手术病例的重要X线征象的特点。方法:回顾性分析5年共20例患者的腹部平片和钡灌肠资料,对其影像学征象进行观察、分析。结果:(1)病理类型构成中,长节段类型比例高,略占25%。(2)新生儿HD表现为肠动力性改变、结肠梗阻和低位小肠梗阻,以肠动力改变和结肠梗阻更多见(共15例)。肠穿孔发生率高,本组2例。(3)除开2例胎儿型结肠,其余13例钡灌肠中,多数病例出现典型的狭窄段(12例)、移行段(13例)和扩张段(12例),重要征象有直肠痉挛切迹(12例)、扩张段的高张力征(10例)和痉挛收缩征(12例)、24h钡残留(13例)和钡便混合征(10例)。结论:新生儿期HD的临床表现、构成类型和影像学表现具有不同于其他时期的特点,各种影像征象主要集中在狭窄段和扩张段,对扩张段的功能变化规律有必要进行系统研究。

Objectives：To study the roentgenographic signs of Hirschsprung＇s disease （HD） proved by surgery and pathology in neonate.Methods：The roentgenographic manifestations and related X-ray signs of twenty cases in the nearest five years were retrospectively observed and analyzed. Results： （1） long-segment types accounted for 25% of all cases. （2） Intestinal motility abnormality, colonic obstruction and low small intestinal obstruction were the main manifestations of abdominal plain film, in which the former two accounted for 94%. Intestinal perforation was a relatively common complication （2cases）. （3） Important signs of barium enema included local notch in the narrow rectum （12cases）,high tension sign （10cases） and spasm-and-contraction sign（12cases） in dilated loop, barium retention （13） and mixed barium-and-stool pattern （10） after 24 hours of follow-up. Conclusion：There is signifcantly difference between HD in neonatal and other period with regard to clinical feature, subtype profile and roentgenographic manifestation. It remains necessary to systemically research on the functional change of colon loop.