儿童肠重复畸形的超声诊断及漏误诊分析

Ultrasonic Diagnosis and Misdiagnosis of Intestinal Duplication in Children

目的探讨超声在儿童肠重复畸形诊断中的价值,分析漏误诊原因,提高超声在肠重复畸形诊断中的正确率。方法回顾性分析2016年4月—2021年4月苏州大学附属儿童医院经手术病理确诊的61例儿童肠重复畸形的临床资料,结合其超声表现、临床及病理特点进行分析、总结。结果61例肠重复畸形确诊病例中,超声明确诊断49例;9例误诊:3例误诊为梅克尔憩室,2例误诊为后腹膜畸胎瘤,1例误诊为肠系膜囊肿,1例误诊为阑尾炎,1例误诊为囊性畸胎瘤,1例误诊为胆总管囊肿;3例漏诊:1例因合并肠套叠漏诊,1例因合并肠梗阻漏诊,1例因小肠、结肠多部位病变漏诊。结论儿童肠重复畸形临床特异性较低,易漏误诊,超声简便、快捷、无放射性,是术前诊断、术后复查的首选检查方法。

Objective To explore the value of ultrasound in the diagnosis of intestinal duplication in children,and analyze the causes of missed diagnosis and improve the accuracy of ultrasound in the diagnosis of intestinal duplication.Methods The clinical data of 61 children with intestinal duplication confirmed by surgery and pathology from April 2016 to April 2021 in Children's Hospital of Soochow University were analyzed retrospectively,combined with their ultrasonic manifestations,clinical and pathological features.Results Among 61 confirmed cases of intestinal duplication,49 cases were definitely diagnosed by ultrasound.9 cases were misdiagnosed:3 cases were misdiagnosed as Meckel diverticulum,2 cases as retroperitoneal teratoma,1 case as mesenteric cyst,1 case as appendicitis,1 case as cystic teratoma and 1 case as choledochal cyst.3 cases were missed diagnosis:1 case was missed diagnosis due to intussusception,1 case was missed diagnosis due to intestinal obstruction,and 1 case was missed diagnosis due to multiple lesions of small intestine and colon.Conclusion Children's intestinal duplication is low in clinical specificity,easy to be missed and misdiagnosed.Ultrasound is simple,rapid and non-radioactive,which is the first choice for preoperative diagnosis and postoperative reexamination.