Merrot T, Anastasescu R, Pankevych T, Tercier S, Garcia S, Alessandrini P, Guys J-M
Paediatric Surgery Department, Hôpital Nord, Marseille, France.
Eur J Pediatr Surg. 2006 Feb;16(1):18-23. doi: 10.1055/s-2006-923798.
The aim of this study was to analyse different clinical aspects and embryologic hypotheses of duodenal duplications.
Duodenal duplications occurring since 1995 were recorded. The age of the children at the time of diagnosis, the sex, location of the duplication, type of mucosa, clinical signs, associated lesions, and the type of surgical intervention were defined.
We identified 5 patients (3 girls and 2 boys) who presented with histological or intraoperative findings of duodenal duplication. Their ages ranged from 4 days to 9 years, with the exception of two prenatal diagnoses. Three children were symptomatic: high intestinal obstruction (1 case), digestive bleeding (2 cases). In 1 case we found a palpable abdominal mass and 1 case was completely asymptomatic (prenatal detection). The abnormality was located on the duodenal concavity, originating from the third part in 2 cases and from the second part in 3 cases. All cases were non communicating types, 4 of which were cystic duplications and 1 was a tube-like variety. The epithelial lining was duodenal mucosa in all patients, but gastric heterotopies were identified in 2 cases. We performed two complete resections and 3 intraduodenal derivations. The outcome was uneventful in 5 cases with an average follow-up of 2 years.
Duodenal duplications are rare malformations with several anatomical varieties. The preferred treatment for duodenal duplications is complete removal when the location allows it without endangering nearby anatomical structures.
本研究旨在分析十二指肠重复畸形的不同临床特征及胚胎学假说。
记录1995年以来发生的十二指肠重复畸形病例。明确患儿诊断时的年龄、性别、重复畸形的位置、黏膜类型、临床症状、相关病变以及手术干预方式。
我们确定了5例（3例女孩和2例男孩）有十二指肠重复畸形组织学或术中表现的患者。他们的年龄从4天到9岁不等，其中2例为产前诊断。3例患儿有症状：高位肠梗阻（1例）、消化道出血（2例）。1例可触及腹部肿块，1例完全无症状（产前发现）。畸形位于十二指肠凹面，2例起源于第三部分，3例起源于第二部分。所有病例均为非交通型，其中4例为囊性重复畸形，1例为管状重复畸形。所有患者的上皮内衬均为十二指肠黏膜，但2例发现胃异位。我们进行了2例完整切除和3例十二指肠内引流术。5例患者术后情况良好，平均随访2年。
十二指肠重复畸形是罕见的畸形，有多种解剖类型。十二指肠重复畸形的首选治疗方法是在位置允许且不危及附近解剖结构时进行完整切除。
