在儿童中,胃肠道穿孔与的腹部创伤
Victoriya Staab1,2, Srividya Naganathan1,2, Margaret McGuire1,2
1Department of Surgery and Pediatrics, K. Hovnanian Children's Hospital at Jersey Shore University Medical Center, Neptune, NJ 07753, USA.
Children (Basel, Switzerland)
|June 27, 2024
概括
诊断儿科肠道穿孔是具有挑战性的,因为成像的限制. 临床评估对于疑似胃肠道穿孔的儿童的手术决定至关重要.
科学领域:
- 儿科手术 儿科手术
- 腹部创伤 腹部创伤
- 胃肠道疾病 胃肠道疾病
背景情况:
- 胃肠道穿孔是儿科形腹部创伤的罕见并发症,发生在不到10%的病例中.
- 由于诊断成像方法的局限性,儿童肠道穿孔的准确诊断受到阻碍.
- 只有50%的儿科病例检测到腹腔内空气,超声波在三分之二的病例中是不特定的.
研究的目的:
- 为了突出儿童肠道穿孔的诊断挑战.
- 强调临床检查在儿科腹部创伤手术决策中的重要性.
- 审查儿童胃肠道穿孔的管理策略.
主要方法:
- 对儿科肠道穿孔的诊断成像准确性的审查,包括超声波和计算机断层扫描 (CT).
- 分析临床检查在指导手术干预中的作用.
- 对儿科胃肠道穿孔的外科治疗选择的评估.
主要成果:
- 计算机断层扫描 (CT) 扫描显示,检测肠道穿孔的灵敏度为50%,特异性为95%.
- 临床检查对于外科决定至关重要,即使CT结果正常.
- 手术管理涉及50-70%的病例的初级修复和20-40%的病例的解剖.
结论:
- 儿童肠道穿孔诊断需要仔细的临床评估,因为可变的成像灵敏度.
- 在怀疑儿童的穿孔时,临床判断应该取代成像发现.
- 儿科胃肠道穿孔的治疗策略已经很成熟,如果可能的话,优先考虑初级修复.
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