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儿童完全性结肠重复畸形

Complete colonic duplication in children.

作者信息

Khaleghnejad Tabari Ahmad, Mirshemirani Alireza, Khaleghnejad Tabari Nasibeh

机构信息

Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Caspian J Intern Med. 2012 Spring;3(2):436-9.

Abstract

BACKGROUND

Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in 15% of gastrointestinal duplication. We report two cases of complete colonic duplications, and their characteristics.

CASE PRESENTATION

We present two patients with complete colonic duplication with different types and presentations. Case 1: A 2- year old boy presented to the clinic with abdominal protrusion, difficulty to defecate, chronic constipation and mucosal prolaps covered bulging (rectocele) since he was 6 months old. The patient had palpable pelvic mass with doughy consistency. Rectal exam confirmed perirectal mass with soft consistency. The patient underwent a surgical operation that had total tubular colorectal duplication with one blind end and was treated with simple fenestration of distal end, and was discharged without complication. After two years follow up, he had normal defecation and good weight gain. Case 2: A 2 -day old infant was referred with imperforate anus and complete duplication of recto-sigmoid colon, diphallus, double bladder, and hypospadiasis. After clinical and paraclinical investigations, he underwent operations in several stages in different periods, and was discharged without complications. After four years follow up, he led a normal life.

CONCLUSION

The patients with complete duplication have to be examined carefully because of the high incidence of other systemic anomalies. Treatment includes simple resection of distal common wall, fenestration, and repair other associated anomalies.

摘要

背景

全结肠重复是一种非常罕见的先天性异常,根据其位置和大小可能有不同表现。全结肠重复可发生于15%的胃肠道重复病例中。我们报告两例全结肠重复病例及其特征。

病例报告

我们呈现两例具有不同类型和表现的全结肠重复患者。病例1:一名2岁男孩自6个月大起就因腹部膨隆、排便困难、慢性便秘以及黏膜脱垂覆盖膨出(直肠膨出)就诊。患者可触及盆腔肿块,质地如面团。直肠检查证实直肠周围有质地柔软的肿块。该患者接受了手术,术中发现全管状结肠重复,一端为盲端,并对远端进行了简单开窗处理,术后无并发症出院。经过两年随访,他排便正常,体重增长良好。病例2:一名2日龄婴儿因肛门闭锁、直肠乙状结肠完全重复、双阴茎、双膀胱和尿道下裂前来就诊。经过临床和辅助检查后,他在不同时期分几个阶段接受了手术,术后无并发症出院。经过四年随访,他生活正常。

结论

由于其他全身异常的发生率较高,对于全结肠重复患者必须进行仔细检查。治疗方法包括简单切除远端共同壁、开窗以及修复其他相关异常。

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