Erginel Basak, Soysal Feryal Gun, Ozbey Huseyin, Keskin Erbug, Celik Alaattin, Karadag Aslıhan, Salman Tansu
Department of Pediatric Surgery, Istanbul University Istanbul Medical Faculty, Millet caddesi, Capa, Fatih, 34093, Istanbul, Turkey.
World J Surg. 2017 Feb;41(2):620-624. doi: 10.1007/s00268-016-3742-4.
The purpose of the study was to evaluate our experience with enteric duplication cysts in 40 children during the past 26 years, while assessing the variability of their presentations and to propose an algorithm for surgical management.
We retrospectively analysed sex, age, clinical presentations, duplication site, surgical treatment, presence of ectopic tissue, complications, associated anomalies, and prognosis of 40 patients with gastrointestinal tract duplications who were surgically treated in our clinic.
Overall, there was a predominance of boys (28 males, 70 %; 12 females, 30 %). The presenting symptom was vomiting in 23 patients, rectal bleeding in 11 patients, abdominal mass in 10 patients, abdominal pain in 9 patients, constipation in 6 patients, cough in 2 patients, and respiratory distress in 2 patients. In 30 patients, a complete excision of the cyst with additional segmental intestinal resection and anastomosis was performed. Cystectomy was performed in seven patients, while complete excision of the cyst with additional wedge resection was performed in two. A Wrenn procedure (mucosectomy) was performed in one patient.
Due to the variability in the site of enteric duplications, a wide range of presenting symptoms can exist, which is challenging for diagnosis. In children with a diagnosis of acute abdomen, enteric duplication cysts should be considered, and these children should be further investigated for additional skeletal, urogenital, and gastrointestinal system pathologies. Surgical treatment depends on the site and type of the cyst.
本研究旨在评估我们在过去26年中对40例儿童肠重复囊肿的治疗经验，同时评估其临床表现的变异性，并提出手术管理的算法。
我们回顾性分析了在我们诊所接受手术治疗的40例胃肠道重复患者的性别、年龄、临床表现、重复部位、手术治疗、异位组织的存在、并发症、相关异常和预后。
总体而言，男性占优势（28例男性，70%；12例女性，30%）。主要症状为呕吐23例，直肠出血11例，腹部肿块10例，腹痛9例，便秘6例，咳嗽2例，呼吸窘迫2例。30例患者进行了囊肿完整切除并附加节段性肠切除及吻合术。7例患者进行了囊肿切除术，2例患者进行了囊肿完整切除并附加楔形切除术。1例患者进行了雷恩手术（黏膜切除术）。
由于肠重复部位的变异性，可能存在广泛的临床表现，这对诊断具有挑战性。对于诊断为急腹症的儿童，应考虑肠重复囊肿，并且应对这些儿童进一步检查是否存在其他骨骼、泌尿生殖系统和胃肠道系统病变。手术治疗取决于囊肿的部位和类型。
