摘要
目的探讨双气囊小肠镜(double-balloon enteroscopy,DBE)联合腹腔镜在儿童梅克尔憩室(Meckel's diverticulum,MD)中的诊治价值.方法回顾性分析武汉市儿童医院消化内科2013-10/2015-10 15例不明原因血便患儿的临床资料,这些患儿均经常规胃镜、结肠镜、放射性核素99mTc扫描显像及血液生化检查未发现病灶但出血反复而住我科,在气管插管+静脉麻醉下经肛DBE检查从而明确诊断"MD",联合腹腔镜进行MD切除、肠吻合术.结果经肛DBE检查发现15例不明原因血便患儿距回盲瓣约30-90 cm回肠"MD",其中5例憩室内可见溃疡,立刻联合在腹腔镜下进行"MD切除、肠吻合术",术后病理诊断与临床符合.结论 DBE检查对儿童M D的诊断安全可靠,联合腹腔镜治疗改变了术前诊断困难的局面,避免盲目地剖腹探查,创伤小;具有很重要的临床价值.
AIM To explore the value of double-balloon enteroscopy（DBE） combined with laparoscopy for diagnosis and treatment of Meckel＇s diverticulum（MD）in children.METHODS Clinical data for 15 children with agnogenic hematochezia treated at our department from October 2013 to October 2015 were retrospectively analyzed.Despite recurrent bleeding,no bleeding lesions were found by conventional gastroscopy,colonoscopy,radionuclide ^99mTc scanning imaging and blood biochemical examination.MD was confirmed by anal DBE examination under tracheal intubation and intravenous anesthesia.Resection of Meckel＇s diverticulum and intestinal anastomosis were performed with the assistance oflaparoscopy.RESULTS By anal DBE,15 children with unexplained bleeding were found to have ileal MD about30-90 cm away from the ileocecal valve,5 of which had diverticulum ulcer.MD resection and intestinal anastomosis were performed immediately with the assistance oflaparoscopy,and postoperative pathological diagnosis was in accordance with clinical diagnosis.CONCLUSION DBE examination is safe and reliable for diagnosis of MD in children.DBE combined with laparoscopy can overcome the difficulty of preoperative diagnosis to avoid blind laparotomy and lead to small trauma.Therefore,double-balloon enteroscopy combined with laparoscopic treatment has important clinical value in the diagnosis and treatment of MD in children.
出处
《世界华人消化杂志》
CAS
2016年第25期3717-3722,共6页
World Chinese Journal of Digestology
关键词
双气囊小肠镜
腹腔镜
儿童
梅克尔憩室
Double-balloon enteroscopy
Laparoscopy
Children
Meckel＇s diverticulum
