婴幼儿急性肠套叠

S. Franchi (Praticien attaché) , H. Martelli (Professeur des Universités - praticien hospitalier) , A. Paye-Jaouen (Chef de clinique - Assistant des hôpitaux de Paris) , D. Goldszmidt (Pédiatre - Attaché consultant) , D. Pariente (Praticien hospitalier, Chef du service de radiologie pédiatrique)
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引用次数: 9

摘要

急性肠套叠(AII)在婴儿和儿童的定义是肠的一部分内陷到自己。其后果是肠梗阻,静脉受压和水肿导致肠坏死。因此,这是一个紧急情况。有两种类型的AII:特发性AII在婴儿中占90%至95%;继发于局部病变(梅克尔憩室、息肉…)或发生于消化道疾病(Henoch-Schönlein紫癜、囊性纤维化…)或特殊情况(术后AII)的AII。腹部超声是诊断婴儿急性腹痛和呕吐的关键成像程序。如果没有禁忌症,采用气动或静压技术进行非手术复位是一线治疗,成功率为80%至90%。手术治疗是在非手术复位失败或特殊情况下进行的二次手术。在儿科医生、外科医生、放射科医生和麻醉科医生的密切合作下,急性呼吸道感染的预后良好。
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Invagination intestinale aiguë du nourrisson et de l’enfant

Acute intestinal intussusception (AII) in infants and children is defined by the invagination of a portion of the intestine into itself. The consequence is an intestinal obstruction with venous compression and oedema leading to intestinal necrosis. AII constitutes therefore an emergency case. There are 2 kinds of AII: the idiopathic AII in infants that represents 90 to 95% of the cases; the AII that is secondary to a localized lesion (Meckel’s diverticulum, polyp…) or occurring in a digestive disease (Henoch-Schönlein purpura, cystic fibrosis…) or in special circumstances (postoperative AII). Abdominal ultrasound is the key imaging procedure that allows diagnosing AII in infants with acute abdominal pain and vomiting. Non operative reduction by pneumatic or hydrostatic techniques is the first-line treatment, if there is no contra-indication, with a success rate observed to be 80 to 90%. Surgical treatment is a secondary procedure performed in case of failure of non operative reduction or in specific circumstances. The prognosis of AII is excellent, conditioned by a close collaboration between paediatricians, surgeons, radiologists and anaesthesiologists.

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