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我院于2002年4月和11月,共收治先天性胃幽门隔膜患儿2例,其中1例合并先天性肥厚性幽门狭窄,现报告如下: 例1:女,因“娩出窒息、复苏后1/2h”入我院新生儿科治疗(其胞姐于1998年因“幽门狭窄”在外院二次手术失败后夭折)。第3d病情好转,有排便,予试喂奶,但患儿吃奶后即呕吐。X线平片示:胃扩张。经予禁食、胃肠减压等处理,3d后试喂糖水后仍反复呕吐,不含胆汁,伴腹胀明显,未排大便。消化道碘油造影示:胃扩张、幽门梗阻。反复触摸于右上腹肋缘下可及一橄榄样质硬包块,大小约2 cm×1.2 cm,活动。诊断:先天性肥厚性幽门狭窄、幽门隔膜?于生后第8 d手术:见幽门约Zcm×1.2 cm,质硬、色稍发白,光滑,于幽门包块前上方无血管区纵形切开浆膜及环肌浅层肌纤维,长约2 cm,幽门钳分离环肌
In our hospital in April 2002 and November, a total of 2 cases of children with congenital stomach pyloric septum were treated, of which 1 case of congenital hypertrophic pyloric stenosis, are as follows: Example 1: Female, due to “delivered asphyxia, after resuscitation 1 / 2h ”into our hospital neonatal treatment (the sister of his sister in 1998 due to“ pyloric stenosis ”in the second hospital after the failure of surgery failed). The first 3d condition improved, defecation, to test feeding, but children vomiting after feeding. X-ray showed: stomach dilation. After fasting, gastrointestinal decompression and other treatment, after 3 days after the test is still repeated vomiting of sugar water, without bile, with abdominal distension significantly, not row stool. Gastrointestinal iodine imaging shows: stomach dilatation, pyloric obstruction. Repeatedly touching the right upper abdomen ribs can reach an olive-like hard mass, the size of about 2 cm × 1.2 cm, activity. Diagnosis: Congenital hypertrophic pyloric stenosis, pyloric septum in the first 8 days after surgery: see pylorus about Zcm × 1.2 cm, hard, slightly white hair, smooth, in the pylorus mass before the top of the non-vascular longitudinal incision Open the serosa and superficial muscle fibers, about 2 cm, pyloric pyloric separation of the ring muscle