每日一题_2024.05.30

A 3-year-old boy who had been born prematurely was brought to the emergency department with a 1-day history of intermittent abdominal pain, nausea, and vomiting. He had had no bloody stools or contact with persons known to be sick. His vital signs were normal. An abdominal examination was notable for hypoactive bowel sounds and tenderness in the right lower quadrant. Ultrasonography of the right lower is shown in the left image. A longitudinal view of the same lesion is shown in the right image. What is this patient’s diagnosis?

一个早产儿，3岁，因为间歇性腹痛、恶心和呕吐1天被带到急诊科。他没有血便，也没有与已知生病的人接触。他的生命体征正常。腹部检查显示肠鸣音减弱，右下腹有压痛。右下腹的超声图像显示在左侧图像中。同一病变的纵向视图显示在右侧图像中。

A. Acute gastroenteritis

B. Appendicitis

C. Enteric duplication cyst

D. Ileoileal intussusception

E. Meckel’s diverticulum

答案解析：

诊断为回肠回肠套叠。右下腹部的超声检查显示了一个靶征病变（左侧图像）。同一病变的纵向视图显示了一段小肠套入自身——这一发现被称为“套筒征”（右侧图像）。套叠是儿童肠梗阻的最常见原因。在大多数情况下，小肠套叠会自行复位。在出现症状3天后，进行了腹部超声的随访检查，没有发现作为病理性引导点的肿块。与大多数儿童小肠套叠的情况一样，患者的这一事件被认为是特发性的。

正确答案：D