Teklali Y, Kaddouri N, Barahioui M
Service de chirurgie viscérale infantile A, Hôpital d'enfants de Rabat, Maroc.
Arch Pediatr. 2002 Sep;9(9):903-6. doi: 10.1016/s0929-693x(02)00020-9.
Digestive duplications are a rare condition in children, characterized by an important anatomoclinical polymorphism. Diagnosis suspected on clinics and evoked by radiology, require histological confirmation.
Nineteen children with duplications were managed in our department, from 1989 to 2001: their hospital chart was retrospectively studied.
Ten of our patients were less than one year of age, ten were boys and nine were girls. Clinical signs consisted of pain and abdominal mass, with some transit disturbs, and these signs led to ultrasonography and tomodensitometry. In one case alimentary tract duplication was revealed by digestive hemorrhage, leading to scintigraphic study. The digestive duplications were localized on the stomach in one case, the duodenum in two cases, the jejuno-ileum in twelve cases, the colon in two cases, and the rectum in two cases. Five digestive duplications were tubular, with one communicating duplication. All cases benefited from surgical treatment, and resection procedure was chosen according to duplication type and site. Histological study showed eight cases of ectopic mucosa, six ectopic gastric mucosa and two pancreatic ectopic mucosa.
Diagnosis and surgical precocious treatment of digestive duplications are the only way to warn complications of this benign pathology.
消化道重复畸形在儿童中是一种罕见疾病,具有重要的解剖临床多态性。临床怀疑诊断并经放射学提示,需组织学确诊。
1989年至2001年,我科收治了19例消化道重复畸形患儿,对其病历进行回顾性研究。
我们的患者中10例年龄小于1岁,10例为男孩,9例为女孩。临床症状包括疼痛、腹部肿块,伴有一些排便障碍,这些症状导致了超声检查和计算机断层扫描。1例因消化道出血发现消化道重复畸形,进而进行了闪烁扫描研究。消化道重复畸形位于胃1例,十二指肠2例,空肠-回肠12例,结肠2例,直肠2例。5例消化道重复畸形为管状,其中1例为交通性重复畸形。所有病例均接受了手术治疗,并根据重复畸形的类型和部位选择了切除手术。组织学研究显示8例异位黏膜,6例异位胃黏膜,2例异位胰腺黏膜。
消化道重复畸形的诊断和早期手术治疗是预防这种良性病变并发症的唯一方法。