| 夏惠玲,刘庆华.儿童梅克尔憩室并发肠梗阻超声表现[J].中国医学影像技术,2025,41(12):2022~2025 |
| 儿童梅克尔憩室并发肠梗阻超声表现 |
| Ultrasonic manifestations of Meckel diverticulum complicated with intestinal obstruction in children |
| 投稿时间：2025-04-18 修订日期：2025-11-14 |
| DOI：10.13929/j.issn.1003-3289.2025.12.018 |
| 中文关键词: 儿童 梅克尔憩室 肠梗阻 超声检查 |
| 英文关键词:child Meckel diverticulum intestinal obstruction ultrasonography |
| 基金项目:山东省医药卫生科技项目(202309021014)。 |
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| 中文摘要: |
| 目的 观察不同诱因致儿童梅克尔憩室(MD)并发肠梗阻(IO)超声表现。方法 回顾性分析82例经手术病理证实的MD并发IO患儿,观察其超声表现。结果 82例中,30例(30/82,36.59%)为MD索带或粘连索带压迫肠管,19例(19/82,23.17%)为MD引发肠套叠,19例(19/82,23.17%)系MD炎致肠粘连,6例(6/82,7.32%)为憩室疝,4例(4/82,4.88%)为MD根部扭转,2例(2/82,2.44%)MD内异物、2例(2/82,2.44%)MD引发肠扭转诱发IO。logistic回归分析显示,MD索带或粘连索带压迫肠管、MD引发肠套叠及MD炎致肠粘连均为MD并发IO的高危因素(P均＜0.05)。除不同程度肠管扩张外,MD并发IO还可见以下超声表现:①MD内翻、内陷致肠套叠,腹腔内可探及横切面呈"靶环"样的肠套叠包块,套环表现多样,套环内可见管状或囊袋状结构回声,憩室黏膜内翻内陷形成增强回声团,憩室空瘪形成低回声结节样改变;②MD索带或粘连索带与受压肠管呈"十字交叉"征;③MD内存在异物时,可见具有异物特征的强回声;④憩室疝可见扩张肠管与空瘪肠管卡压内侧缘形成的"鸭梨"状囊性包块,以及远端小肠及结肠充盈不良;⑤MD根部扭转或引发肠扭转时,动态扫查表现为"旋涡"征。结论 超声可明确诊断MD并发IO并在一定程度上判断其诱因,为临床精准治疗提供依据。 |
| 英文摘要: |
| Objective To observe ultrasonic manifestations of Meckel diverticulum (MD) complicated with intestinal obstruction (IO) in children with different incentives. Methods Data of 82 pediatric patients with MD complicated with IO confirmed by surgical pathology were retrospectively analyzed, and the ultrasonic manifestations were observed. Results Among 82 cases, IO was induced by compression of MD bands or adherent bands of intestinal tract in 30 cases (30/82, 36.59%), by MD-induced intussusception in 19 cases (19/82, 23.17%), by intestinal adhesion due to MD inflammation in 19 cases (19/82, 23.17%), by diverticular hernia in 6 cases (6/82, 7.32%), by MD root torsion in 4 cases (4/82, 4.88%), and by foreign bodies in MD in 2 cases (2/82, 2.44%), by MD-induced intestinal volvulus in 2 case (2/82, 2.44%). Logistic regression analysis revealed that MD bands or adherent bands compression of intestinal tract, MD-induced intussusception, as well as intestinal adhesion caused by MD inflammation were all high-risk factors of IO complicated with MD (all P＜0.05). In addition to different degrees of intestinal dilatation, the above ultrasonic manifestations were observed when MD complicated with IO: ①MD inversed and entrapped leading to intussusception, present a "target ring" sign in transverse cross-section of the intussusception mass in abdominal cavity, showing diverse loop manifestations, including tubular or cystic echo structures within loop, enhanced echo masses formed by diverticular mucosa inversion and entrapment, also low-echo nodular changes due to diverticular collapse; ②MD bands or adherent bands present a "cross-shaped" sign with the compressed intestinal tract; ③foreign bodies in MD displayed clearly strong echoes with relatives characteristics; ④diverticular hernia showed as "pear-shaped" cystic mass pressing against the inner edge of the dilated and collapsed intestinal tract, with poor filling of the distal small intestine and colon; ⑤dynamically visible "vortex" sign when MD root torsion or induced intestinal torsion occurred. Conclusion Ultrasound could clearly diagnose MD complicated with IO in children and judging the incentives in a certain degree, providing evidences for timely precise treatment. |
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