Department of Pediatrics, Keelung Hospital, Department of Health, Executive Yuan, Taiwan; Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
Pediatr Neonatol. 2012 Feb;53(1):12-7. doi: 10.1016/j.pedneo.2011.11.004. Epub 2012 Jan 17.
To classify and evaluate the clinical spectrum of congenital webs in the gastrointestinal (GI) tract, including clinical courses and related factors.
A retrospective chart review was performed on 37 patients with congenital GI webs at a pediatric care teaching hospital in north Taiwan. All of the related parameters were collected and analyzed.
Twelve patients had gastric webs, 22 had duodenal webs, and three had jejunal webs. The mean time to diagnosis was 1576 days for gastric webs, 116 days for duodenal and 230 days for jejunal webs. There was a statistically significant difference between the gastric and duodenal groups (p = 0.001). The major symptom was vomiting (78%). Patients with duodenal webs had a high association with congenital anomalies (50%). The major anomalies included cardiac (27%) and GI anomalies (18%). Endoscopy was performed in 10 gastric cases, and all of them were noted to have positive findings, including a fixed nonfolded stenotic ring following a second gastric chamber and a real pylorus. All of the patients received surgery except for three with gastric webs, and no mortality was noted. The mean postoperative days of tolerated feeding was 6 for those with gastric webs, 10 for those with duodenal and 11 for those with jejunal webs.
The clinical course of gastrointestinal webs may be chronic or obscure. A delay from onset of symptoms to treatment may exist, especially in gastric webs. We suggest that prompt endoscopic confirmation and surgical intervention for these lesions, when suspected due to clinical and radiologic abnormalities, will decrease the morbidity of unexplained recurrent symptoms or signs of GI obstruction in these patients.
为了对胃肠道（GI）先天性索带进行分类和评估，包括临床病程和相关因素。
对台湾北部一家儿科护理教学医院的 37 名先天性 GI 索带患者进行回顾性病历审查。收集并分析所有相关参数。
12 例患者有胃索带，22 例患者有十二指肠索带，3 例患者有空肠索带。胃索带的平均诊断时间为 1576 天，十二指肠索带为 116 天，空肠索带为 230 天。胃索带和十二指肠索带组之间存在统计学差异（p=0.001）。主要症状是呕吐（78%）。患有十二指肠索带的患者与先天性异常高度相关（50%）。主要异常包括心脏（27%）和 GI 异常（18%）。10 例胃索带患者进行了内镜检查，均发现阳性结果，包括第二个胃腔后固定的非折叠狭窄环和真正的幽门。除 3 例胃索带患者外，所有患者均接受了手术治疗，无死亡病例。胃索带患者术后可耐受喂养的平均天数为 6 天，十二指肠索带为 10 天，空肠索带为 11 天。
胃肠道索带的临床病程可能是慢性或隐匿性的。从症状发作到治疗可能存在延迟，尤其是在胃索带中。我们建议，当临床和影像学异常怀疑存在这些病变时，及时进行内镜确认和手术干预，将降低这些患者不明原因反复发作的胃肠道梗阻症状或体征的发病率。
