Koffie Robert M, Lee Sang, Perez-Atayde Antonio, Mooney David P
Department of Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
Pediatr Surg Int. 2012 Oct;28(10):1035-9. doi: 10.1007/s00383-012-3116-4. Epub 2012 Jul 1.
Enteric duplication cysts are rare congenital anomalies of unclear etiology. While they can occur anywhere in the gastrointestinal tract, they typically occur in the ileum or ileocecal region and very rarely in the duodenum. Here, we report a case of a periampullary duodenal duplication cyst in a 13-year-old male who presented with clinical and laboratory evidence of small bowel obstruction, hepatitis, and pancreatitis. Based on radiologic imaging, the patient was thought to have a type III choledochal cyst (choledochocele) within the duodenal lumen. Intraoperative findings and postoperative pathological evaluation, however, revealed that the lesion was a duodenal duplication cyst masquerading as a choledochal cyst. Interestingly, the duplication cyst was communicating with the common bile duct, simultaneously causing biliary and small bowel obstruction.
肠重复囊肿是病因不明的罕见先天性异常。虽然它们可发生于胃肠道的任何部位,但通常发生在回肠或回盲部,很少发生在十二指肠。在此,我们报告一例13岁男性壶腹周围十二指肠重复囊肿病例,该患者表现出小肠梗阻、肝炎和胰腺炎的临床及实验室证据。根据影像学检查,该患者被认为在十二指肠腔内有III型胆总管囊肿(胆总管膨出)。然而,术中发现及术后病理评估显示,该病变是伪装成胆总管囊肿的十二指肠重复囊肿。有趣的是,该重复囊肿与胆总管相通,同时导致胆道和小肠梗阻。