摘要
目的:探讨先天性胆总管囊肿自发性穿孔的诊断方法和手术方式。方法:回顾性分析16例先天性胆总管囊肿自发性穿孔患儿的临床资料。结果:本组16例患儿年龄均小于4岁,平均年龄23个月。临床表现为腹胀、腹痛、呕吐及发热,同时有全腹压痛。10例术前经腹腔穿刺明确胆道自发性穿孔的诊断,其中5例经B超或CT检查证实有胆总管囊肿。采用囊肿外引流加腹腔引流治疗。16例患儿术后均恢复良好,3个月左右再行囊肿切除加胆道重建。结论:先天性胆总管囊肿穿孔与胆道梗阻有关。急诊治疗宜选择囊肿外引流术,而后再行囊肿切除和胆道重建。
Objective :To investigate the diagnosis and operative procedure for spontaneous perforation of congenital eholedochal cyst in children. Methods:The clinical data of 16 cases with spontaneous perforation of congenital choledochal cyst were analysed retrospectively. Results : AIl cases were under 4 years old with a mean age of 23 months. Abdominal distension, pain, vomiting, fever and diffuse tenderness were present in all patient3. The preoperative diagnosis was established by paraeente- sis intenpatients. Abdominal sonography and CT found a cyst in 5 of the 10 cases reviewed. In 11 cases(68.7% ) ,the site of perforation was found on the confluence of common bile duct and gallbladder cystic duct. T - tube drainage was used as s transition measure. A11 patients recovered uneventfully. Radical resection was performed in about three months after the initial operation. Concinsions:The obstruction of the bile duct and poor blood supply to the choledochal cyst are major causes leading to perforation. Routine abdominal paracentesis should be carded out for a small child with peritonitis and general abdominal tenderness,especially on the right upper quadrant. T - tube drainage should be adopted as an emergent procedure to tide the patient over the crisis followed by elective choledochal cyst resection and bile duet recon- struction.
出处
《医学信息(中旬刊)》
2011年第3期820-821,共2页
Medical Information Operations Sciences Fascicule
关键词
胆总管囊肿
腹膜炎
Choledochal cyst
Peritonitis