Kosir M A, Sonnino R E, Gauderer M W
Department of Surgery, Rainbow Babies and Childrens Hospital, University Hospitals of Cleveland, Case Western Reserve University School of Medicine, OH.
J Pediatr Surg. 1991 Nov;26(11):1309-13. doi: 10.1016/0022-3468(91)90607-u.
Abdominal lymphangiomas are usually classified together with mesenteric cysts. However, they differ by location, histology, and potential for recurrence, and should be considered a separate clinical entity. Thirteen children, aged 2 weeks to 11 years (mean, 5.8 years), with abdominal lymphangiomas were identified over the past 16 years at this institution. Of these, 12 were symptomatic. Abdominal pain (11), vomiting (8), increased abdominal girth (8), and nausea (6) predominated. Other presentations were less frequent. Symptoms were present for an average of 2 months (7 less than 1 week) before correct diagnosis. An abdominal mass was palpable in 10 cases. Intestinal gangrene secondary to volvulus was present in 2. Although multiple imaging modalities were used ultrasonography (8/8) and computed tomography (CT; 4/4) proved most expedient and reliable. In 2 cases, the lymphangioma could not be completely resected. There was 1 recurrence. Although intraabdominal cystic lesions are described in the literature as relatively symptom-free, our experience suggests otherwise. In this series, abdominal pain and an abdominal mass were common. Catastrophic complications can occur and excision is facilitated by earlier diagnosis and the benefit of smaller size. Ultrasound and CT can accurately diagnose the lesion and should be used liberally in children with intermittent or ill-defined abdominal pain, leading to prompt recognition and definitive treatment.
腹部淋巴管瘤通常与肠系膜囊肿归为一类。然而，它们在位置、组织学和复发可能性方面存在差异，应被视为一个独立的临床实体。在过去16年里，该机构共确诊了13例腹部淋巴管瘤患儿，年龄从2周至11岁（平均5.8岁）。其中12例有症状。主要症状为腹痛（11例）、呕吐（8例）、腹围增大（8例）和恶心（6例）。其他表现则较少见。在正确诊断前，症状平均持续2个月（7例少于1周）。10例可触及腹部肿块。2例出现肠扭转继发肠坏疽。虽然使用了多种影像学检查方法，但超声检查（8/8）和计算机断层扫描（CT；4/4）被证明是最便捷和可靠的。2例淋巴管瘤无法完全切除。有1例复发。尽管文献中描述腹腔内囊性病变相对无症状，但我们的经验却并非如此。在本系列中，腹痛和腹部肿块很常见。可能会发生灾难性并发症，早期诊断及肿瘤较小有利于切除。超声和CT能够准确诊断病变，对于有间歇性或不明确腹痛的儿童应广泛使用，从而实现及时识别和明确治疗。
