Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
J Pediatr Surg. 2010 Jul;45(7):1554-8. doi: 10.1016/j.jpedsurg.2010.03.017.
The high definition provided by modern imaging techniques allows the delineation of fetal anatomy with unprecedented accuracy. The early prenatal detection of enteric duplications is possible and facilitates a prompt postnatal treatment strategy, thereby, decreasing the risk of potential complications.
We retrospectively reviewed the medical records of all patients treated at our institution with a prenatally diagnosed intraabdominal enteric duplication between 2001 and 2009.
Eighteen patients were included in the series. The diagnosis was made as early as 20 weeks of gestational age and included gastric duplications (3 cases), jejunoileal duplications (11 cases), and duodenal duplications (4 cases). None of the patients had prenatal complications. Two patients had associated intestinal malrotation, whereas the remaining 16 had no other malformations. Postnatally, 14 patients had an uneventful clinical course until the time of surgery, 3 patients had complications within the first 2 weeks of life that required emergency surgery, and 1 patient who had been lost to follow-up presented with duodenal obstruction at 3 years of age. Four patients underwent laparoscopic resection.
Because intraabdominal enteric duplications can cause complications, we believe that prenatally diagnosed enteric duplications should be resected after birth.
现代成像技术提供的高清度使得对胎儿解剖结构的描绘达到了前所未有的精准度。对肠道重复畸形进行早期产前诊断成为可能,并有助于制定及时的产后治疗策略,从而降低潜在并发症的风险。
我们回顾性分析了 2001 年至 2009 年在我院接受治疗的所有产前诊断为腹腔内肠道重复畸形的患者的病历。
本系列纳入了 18 例患者。诊断最早在妊娠 20 周时做出,包括胃重复畸形(3 例)、空肠回肠重复畸形(11 例)和十二指肠重复畸形(4 例)。所有患者均无产前并发症。2 例患者存在肠旋转不良,其余 16 例患者无其他畸形。14 例患者在手术后的临床过程中均未出现并发症,3 例患者在出生后 2 周内出现并发症,需要紧急手术,1 例失访患者在 3 岁时出现十二指肠梗阻。4 例患者接受了腹腔镜切除。
由于腹腔内肠道重复畸形可能导致并发症,我们认为产前诊断的肠道重复畸形应在出生后进行切除。