Hishiki Tomoro, Saito Takeshi, Terui Keita, Mitsunaga Tetsuya, Nakata Mitsuyuki, Matsuura Gen, Yoshida Hideo
Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan.
J Pediatr Surg. 2008 Sep;43(9):e1-3. doi: 10.1016/j.jpedsurg.2008.04.009.
A rare case of gastric duplication of childhood is reported. A 1-month-old boy underwent pyloromyotomy for infantile hypertrophic pyloric stenosis. At laparotomy, a protruding lesion was identified in the anterior wall of the pylorus. The pylorus was hypertrophic as indicated preoperatively, and a normal pyloromyotomy was performed. Wedge biopsy of the protruding lesion revealed an intestinal structure, and gastric duplication was diagnosed. The child remained asymptomatic thereafter, but considering the risk of the duplication becoming symptomatic, a second laparotomy was performed at 1 year of age. The duplication cyst shared part of the wall with the pylorus, and the cyst was removed by cystectomy, leaving the pyloric muscle intact. The cyst was found to be communicating with the pancreatic duct. The child is doing well without any symptoms as of 18 months after second laparotomy. To the best of our knowledge, this is the youngest case of gastroduodenal duplication with pancreatic duct communication yet reported.
本文报道了一例罕见的儿童胃重复畸形病例。一名1个月大的男婴因婴儿肥厚性幽门狭窄接受了幽门肌切开术。在剖腹手术中，发现幽门前壁有一个突出病变。如术前所示，幽门肥厚，遂进行了常规的幽门肌切开术。对突出病变进行楔形活检，结果显示为肠道结构，诊断为胃重复畸形。此后该患儿一直无症状，但考虑到重复畸形出现症状的风险，在其1岁时进行了第二次剖腹手术。重复囊肿与幽门共用部分囊壁，通过囊肿切除术将囊肿切除，幽门肌保持完整。发现囊肿与胰管相通。二次剖腹手术18个月后，患儿情况良好，无任何症状。据我们所知，这是迄今报道的最年幼的伴有胰管相通的胃十二指肠重复畸形病例。
