MALROTATION OF THE INTESTINE IN CHILDREN
MALROTATION OF THE INTESTINE IN CHILDREN
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DOI：
10.1097/00000658-199202000-00013
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发表时间：
1992-02-01
影响因子：
9
通讯作者：
WEITZMAN, JJ
中科院分区：
文献类型：
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作者：
FORD, EG;SENAC, MO;WEITZMAN, JJ
肠旋转不良可合并肠扭转和肠坏死。1977~1987年，102例(男，女38例)行腹部探查术，均发生旋转不良。出生7天以下52例，8~30天13例，31~365天26例，1岁以上11例。在65名婴儿中，39名怀孕40周，18名怀孕36周至39周，8名怀孕不足36周。主要症状包括：胆汁呕吐(47例)、肠梗阻(19例)、腹痛(11例)和便血(7例)。先天畸形70例(单发50例，多发20例)。诊断评估包括56个上胃肠道系列和27个钡灌肠。每例患者均接受了旋转不良矫正术和阑尾切除术，并矫正了先天性畸形(脐腔膨出-9例，腹裂-6例，横隔疝-7例)。并发症包括短肠(2例)、脓毒症(5例)、喂养困难(2例)、肺炎(3例)、肠梗阻(2例)和其他(15例)。死亡9例(8.8%)，其中18三体1例，13三体1例，肠坏死3例，肝功能衰竭1例，早产1例，其他败血症2例。自1937年至1987年，共收治216例肠旋转不良患儿。死亡率从23%提高到2.9%。
Intestinal malrotation may be complicated by volvulus and intestinal necrosis. One hundred two children (64 male, 38 female) undergoing surgical abdominal exploration from 1977 to 1987 had malrotation. Fifty-two patients were less than 7 days of age, 13 from 8 to 30 days, 26 from 31 to 365 days, and 11 were older than 1 year of age. Of infants, 39 of 65 had 40-week gestations, 18 of 65 had 36- to 39-week gestations, and 8 of 65 had less than 36-week gestations. Chief symptomatology included: bilious emesis (47), intestinal obstruction (19), abdominal pain (11), and bloody stools (7). Seventy patients had congenital anomalies (50 single, 20 multiple). Diagnostic evaluations included 56 upper gastrointestinal series and 27 barium enemas. Each patient underwent correction of malrotation and appendectomy, and correction of congenital anomalies (omphalocoele-9, gastroschisis-6, diaphragmatic hernia-7). Complications included short gut (2), sepsis (5), feeding difficulties (2), pneumonia (3), small bowel obstruction (2), and other (15). Nine patients (8.8%) died (trisomy 18-1, trisomy 13-1, intestinal necrosis-3, hepatic failure-1, prematurity-1, other sepsis-2). Two hundred sixteen children with intestinal malrotation have been treated from 1937 to 1987. Mortality rate has improved from 23% to 2.9%.