新生兒的細小結腸症：臨床意義與鑑別診斷

Microcolon in Newborns: Clinical Significance and Differential Diagnosis

許惠春(Wei-Chun Hsu) ； 黃富源(Fu-Yuan Huang) ； 李宏昌(Hong-Chang Lee) ； 施焄鏻(Shin-Lin Shin)

《Acta Paediatrica Sinica》 32卷3期 (1991/06) Pp. 151-157

https://doi.org/10.7097/APS.199106.0151

摘要

新生兒的胃腸道阻塞，常常需要安排下消化道鋇劑攝影檢查，以便在手術前確定阻塞的原因及部位，提供給外科醫師做為閉刀的參考。有時候會遇到整段狹小，似未經使用的結腸，特稱為細小結腸(microcolon)。馬偕醫院小兒科於76年1月至77年12月共有228例新生兒接受下消化道鋇劑攝影檢查。其中20例經放射科醫師判讀為細小結腸（佔8.7%）。包括廻腸閉鎖9例，結腸閉鎖2例，全結腸無神經節細胞症3例，產前腸扭結2例，廻腸胎便阻塞2例，廻腸複製畸形1例，巨膀胱－細小結腸－腸蠕動不良症侯羣1例。我們認為在小腸遠端之腸內阻塞、腸外壓迫、大腸無神經節細胞症及胃腸蠕動不良等會出現細小結腸的現象，但仔細判讀比較單純腹部攝影與下消化道鋇劑攝影，有利於鑑別不同病因，做適當之治療，並可避免一些不必要的手術。

並列摘要

Micorocolon is a radiological finding of a colon of tiny caliber on barium enema examination. There are no absolute standards for measurement of this condition which is probably caused in utero by lack of appropriate distention of the colon with intramural content.
A review was undertaken of 228 barium enema examintions of newborns admitted to Mackay Memorial hospital from January 1987 to December 1988. Twenty cases (8.7%) were regarded by the same radiologist as microcolon. Among them, ileal atresia was found in nine cases (45%); colonic atresia in two cases (10%); total colon agangliosis in three cases (15%); prenatal volvulus in two cases (10%); meconium ileus in two cases (10%); duplication of ileum in one case (5%): and megacystis-microcolon-intestinal hypoperistasis (MMIHS) in one case (5%).
The characteristic features of plain abdomen and barium enema study were discussed. The finding of a microcolon on contrast enema study in newborn with lower gastrointestinal obstruction signifies that it may rise from lower gastrointestinal obstruction above colon, external compression, or motility disorder of the intestine itself.
The outcome of microcolon seems to depend on its underlying causes. In those caused by obstruction, only the caliber may return to normal within days after removal of the obstruction.

並列關鍵字

microcoln ； newborn