回盲部囊肿型肠重复畸形的影像诊治分析

Imaging diagnosis of cystic type intestinal duplications in ileocecal region

目的:探讨回盲部囊肿型肠重复畸形的影像学特点。方法:回顾性分析经手术证实的6例回盲部囊肿型肠重复畸形的影像学表现及临床特点。结果:6例患儿中4例因急腹症入院检查,术前3例影像学诊断为肠套叠,1例诊断为肠梗阻。主要CT表现为回盲部低密度囊性肿块,可见软组织密度环即双环征。4例合并肠套叠或肠梗阻,3例行气钡灌肠示回盲部软组织块影,仅有部分气体进入小肠,均未能彻底整复。结论:回盲部肠重复畸尤其是肠内囊肿型常常合并急腹症而发病,容易漏诊,CT能够做出正确的诊断,合并有肠套叠时气钡灌肠效果不佳,应及早行手术治疗。

Objective： To study the imaging manifestations of cystic type intestinal duplications in ileocecal region. Methods：The imaging features and clinical materials of 6 cases with surgery and pathology proven intestinal duplication in ileocecal region were retrospectively analyzed. Results：Of the six pediatric cases 4 cases presented as acute abdomen and were admitted and examined in hospital,The preoperative imaging diagnosis was intussusception in 3 cases, and intestinal obstruction in 1 case. The predominant CT manifestations were low density cystic mass in ileocecal region,soft tissue densi- ty ring sign （double ring sign） could be assessed. Accompanied intussusception,or bowel obstruction was seen in 4 cases. Air- barium- enema was performed in 3 patients,soft tissue density mass could be assessed and only part of the gas could enter into the small intestine, complete restoration could not be achieved. Conclusion： Intestinal duplication, in ileocecal re- gion, especially the cyst type often presented as acute abdomen, and could be easily mis-diagnosed. Correct diagnosis could be achieved by CT examination. Treatment with air-barium enema was often non-effective when associated with intussuscep- tion, surgical intervention should be done.