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目的探讨新生儿十二指肠梗阻的X线表现及鉴别诊断。方法回顾性分析52例经外科手术证实为十二指肠梗阻的X线资料,每例均行腹部直立位片检查,其中28例行上消化道泛影葡胺检查,36例行钡剂或泛影葡胺灌肠辅助检查。结果腹部直立片见“单泡征”9例,“双泡征”29例,“三泡征”6例,阶梯状多个短小气液平8例。上消化道造影检查显示十二指肠完全梗阻14例,不完全梗阻13例,其中显示空肠位置异常8例。结肠造影检查显示回盲部位置异常30例,伴细小结肠10例。52例中,肠旋转不良34例,十二指肠闭锁9例,十二指肠狭窄4例,环状胰腺5例。结论结合临床病史及腹部直立位片可对十二指肠梗阻做出诊断,鉴别诊断需做上消化道泛影葡胺造影和灌肠辅助检查。
Objective To investigate the X-ray findings and differential diagnosis of neonatal duodenal obstruction. Methods Retrospective analysis of 52 cases of X-ray data confirmed by surgery for duodenal obstruction, each case were performed abdominal abdominal orthopedic examination, of which 28 cases of upper gastrointestinal diatrizophoresis, 36 patients with barium or Meglumine diacetate enema assisted examination. Results Abdominal erections were seen in 9 cases of “single bubble sign”, 29 cases of “double bubble sign”, 6 cases of “three bubble sign” and 8 cases of stepped short multiple gas and liquid level. Upper gastrointestinal angiography showed complete obstruction of the duodenum in 14 cases, incomplete obstruction in 13 cases, which showed abnormal jejunum in 8 cases. Colonic examination showed abnormal ileocecal position in 30 cases, with small colon in 10 cases. In 52 cases, 34 cases of bad bowel rotation, 9 cases of duodenal atresia, 4 cases of duodenal stenosis, 5 cases of annular pancreas. Conclusions Combination of clinical history and abdominal orthostatic radiographs can make a diagnosis of duodenal obstruction, differential diagnosis need to do upper gastrointestinal meglumgeography and enema assisted examination.