Congenital anomalies of the small intestine, colon, and rectum
Congenital anomalies of the small intestine, colon, and rectum
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DOI：
10.1148/radiographics.19.5.g99se041219
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发表时间：
1999-09-01
期刊：
影响因子：
5.5
通讯作者：
del Hoyo, ML
中科院分区：
文献类型：
--
作者：
Berrocal, T;Lamas, M;del Hoyo, ML
先天性胃肠道异常是儿童发病的重要原因，成人发病率较低。这些异常包括小肠发育性梗阻性缺陷、结肠异常、旋转和固定异常、肛门直肠异常和肠重复畸形。完全性高位肠梗阻的新生儿在放射学检查后通常不需要进一步的放射学评估，而完全性低位肠梗阻的新生儿则需要进行造影剂灌肠检查。所有不完全性肠梗阻的患者都必须进行上消化道造影，因为每种情况下的治疗方法不同。在低位肠梗阻，超声检查（US）可以帮助区分小肠梗阻和结肠梗阻。此外，超声可帮助正确识别胎粪性肠梗阻和胎粪性腹膜炎，并有助于诊断肠重复畸形囊肿。在旋转不良和肛门直肠畸形，计算机断层扫描（CT）和磁共振（MR）成像可以提供极好的解剖细节和增加诊断特异性。小肠重复畸形在X线、造影剂灌肠或超声检查时表现为腹部肿块。在CT上，大多数重复表现为光滑的圆形，充满液体的囊肿或管状结构，壁薄，轻度强化。在MR成像中，囊内液体在T1加权图像上具有不均匀的信号强度，在T2加权图像上具有均匀的高信号强度。熟悉这些胃肠道异常是必要的正确诊断和适当的管理。
Congenital anomalies of the gastrointestinal tract are a significant cause of morbidity in children and, less frequently, in adults. These abnormalities include developmental obstructive defects of the small intestine, anomalies of the colon, anomalies of rotation and fixation, anorectal anomalies, and intestinal duplications. Neonates with complete high intestinal obstruction do not usually require further radiologic evaluation following radiography, whereas those with complete low obstruction should, undergo a contrast material enema examination. An upper gastrointestinal series must be performed in all patients with incomplete intestinal obstruction because management is different in each case. In low intestinal obstruction, ultrasonography (US) may help differentiate between small bowel obstruction and colonic obstruction. In addition, US can help correctly identify meconium ileus and meconium peritonitis and is useful in the diagnosis of enteric duplication cysts. In malrotation and anorectal anomalies, computed tomography (CT) and magnetic resonance (MR) imaging can provide superb anatomic detail and added diagnostic specificity. Intestinal duplications manifest as an abdominal mass at radiography, contrast enema examination, or US. At CT, most duplications manifest as smoothly rounded, fluid-filled cysts or tubular structures with thin, slightly enhancing walls. At MR imaging, the intracystic fluid has heterogeneous signal intensity on Tl-weighted images and homogeneous high signal intensity on T2-weighted images. Familiarity with these gastrointestinal abnormalities is essential for correct diagnosis and appropriate management.