儿童术后粘连类型随时间的超声变化

IF 0.3 Q4 PEDIATRICS Journal of Child Science Pub Date : 2022-09-29 DOI:10.1055/s-0042-1757152
S. Alamdaran, Seyed Hamidreza Vahed, Golnaz Seyedin
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引用次数: 0

摘要

术后纤维化带形成是常见的并发症,可引起肠梗阻、慢性疼痛,尤其是再手术问题。我们试图评估儿童不同粘连的超声征象。本描述性研究在马什哈德医科大学儿童医院进行。65名年龄在4个月至15岁(平均年龄7.2±6.5岁)的儿童被纳入研究。由儿科放射科医生使用5至12 MHz多频探头完成腹部超声检查。进行超声检查结果和资料分析。术后第一周,纤维性渗出物可见低回声影。它的厚度不均匀,通常将肠袢包裹成圆形。第二周逐渐变直,厚度均匀。在此期间,68%的病例在低回声纤维渗出物的中心形成高回声线,通常位于肠袢之间(肠袢间纤维化)。纤维性渗出物中的网膜或肠系膜分别发生在50%和25%的病例中。在此状态下,回声大网膜或肠系膜与低回声纤维性渗出物同时可见。术后1个月,可见以下四种超声模式之一:网膜附着于腹膜后高回声(50%),肠系膜附着于前腹壁高回声(26%),袢间纤维化(39%)和严重低回声纤维化带(30%)。65%至80%的患者没有内脏滑动。总的来说,超声显示粘连有五种形态:纤维性渗出物、环间纤维化、纤维化带、固定网膜到腹膜后、固定肠系膜到腹壁。
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Ultrasound Changes of Postoperative Adhesion Types Over Time in Children
Postoperative fibrotic band formation is a common complication that causes bowel obstruction, chronic pain, and especially reoperation problems. We tried to evaluate the ultrasound signs of different adhesions over time in children. This descriptive study was performed in children hospital of Mashhad University of Medical Sciences. Sixty-five children aged 4 months to 15 years (mean age of 7.2 ± 6.5 years) were enrolled in the study. Complete abdominal sonography using 5 to 12 MHz multifrequency probes was performed by a pediatric radiologist. The sonographic findings and data analysis were performed. In first week after surgery, the fibrinous exudates are seen as hypoechoic shadows. It has uneven thickness and usually encases the bowel loops in a circular shape. In second week, they gradually become straighter with uniform thickness. In this period, in 68% of cases, a hyperechoic line is formed in the center of hypoechoic fibrinous exudates, which is usually placed between the bowel loops (interloop fibrosis). The omentum or mesentery entrapment in the fibrinous exudates was occurred in ∼50% and 25% of these cases, respectively. In this state, echogenic omentum or mesentery was seen simultaneously with the hypoechoic fibrinous exudates. After 1 month from surgical procedure, One of the following four sonographic patterns are seen: attachment hyperechoic omentum to retroperitoneum (50%), attachment hyperechoic mesentery to anterior abdominal wall (26%), interloop fibrosis (39%), and severe hypoechoic fibrotic band (30%). Absence of visceral sliding was seen in 65 to 80% of patients. Overall, there are five morphologic patterns of adhesion on ultrasound: fibrinous exudates, interloop fibrosis, fibrotic band, fixed omentum to retroperitoneum, and fixed mesentery to abdominal wall.
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