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Case 2
An 8-year-old boy had acute right flank pain and vomiting. Sonography revealed small-bowel obstruction. The zone of transition between the dilated and nondilated small bowel was seen in the right iliac fossa (Figure 3). There was a cluster of a few loops of crowded, compressed, and aperistaltic small bowel above and to the right of this zone with the suggestion of encapsulation (Figure 4). Because of prior experience with the previous case, a diagnosis of small-bowel obstruction due to internal hernia was made. The patient was taken for surgery without any other investigation.
病例2
一8岁男孩出现急性右侧肋缘疼痛并呕吐。超声显示小肠梗阻。扩张和非扩张小肠肠管临界区位于右侧髂窝（图3），此区域右侧和上方的小部分的小肠肠管堆积受压成胶囊状，蠕动消失（图4）。根据先前病例的经验，诊断为腹内疝导致的小肠梗阻。病人进行了手术治疗而没有再做其他检查。

Figure 3. Oblique scan of the right iliac fossa showing the zone of transition (arrow) of the dilated to nondilated bowel.
图3 右侧髂窝斜向扫描显示扩张和非扩张肠管的过渡区（箭头）。

Figure 4. Oblique scan above and to the right of the zone of transition showing the cluster of crowded and compressed loops.
图4 过渡区右上斜向扫描显示肠管堆积成团并受压。

Case 3
病例3
A 1-year-old girl had a sudden attack of persistent vomiting lasting for almost 24 hours. Sonography was performed with a clinical diagnosis of malrotation of the midgut. It revealed markedly dilated hyperperistaltic small-bowel loops suggestive of small-bowel obstruction.
There was a zone of transition in the right iliac fossa (Figure 5) with a cluster of crowded and compressed loops of small bowel to the right of the zone of transition (Figure 6). The child did not undergo any other imaging investigation. Because the child did not improve with conservative treatment, laparotomy was done, which showed a small-bowel obstruction due to a paracecal internal hernia.
一1岁大的女婴突发持续性呕吐近24小时。临床诊断为中肠旋转不良而进行超声检查，显示小肠明显的扩张，蠕动亢进，提示小肠梗阻。临界区位于右侧髂窝（图5），其右侧的部分的小肠肠管堆积受压（图6）。患儿不能承受其他的影像学检查。由于保守治疗后没能出现改善，患儿进行了腹腔镜检查，发现是盲肠旁的腹内疝导致的小肠梗阻。

Figure 5. Oblique scan in right iliac fossa showing the zone of transition (arrow).
右侧髂窝斜向扫描显示过渡区（箭头）。

Figure 6. Transverse scan showing the cluster of crowded and compressed loops.
横向扫描显示肠管堆积成图并受压。

编辑：bluelove