Tiwari Charu, Shah Hemanshi, Waghmare Mukta, Makhija Deepa, Khedkar Kiran
Department of Paediatric Surgery, T.N.M.C & B.Y.L. Nair Hospital, Mumbai, India.
Pediatr Gastroenterol Hepatol Nutr. 2017 Jun;20(2):94-99. doi: 10.5223/pghn.2017.20.2.94. Epub 2017 Jun 28.
Abdominal cysts of gastrointestinal origin are rare. Their rarity and varied clinical presentations make their pre-operative diagnosis difficult.
Fourteen patients with histological diagnosis of cysts of gastrointestinal origin admitted between 2009 and 2015 were retrospectively analyzed with respect to age, sex, clinical presentation, diagnostic modality, site and type of cyst, management, outcome and follow-up.
The mean age at presentation was 4 years and there were six males and eight females. Abdominal pain was the most common presenting symptom. Five patients had an acute presentation-three had distal ileal mesenteric cysts and two had ileal duplication cyst sharing a common wall with ileum. Six patients presented with chronic abdominal pain and lump-three patients had omental cysts and three had mesenteric cysts-two of these in distal ileum and one in sigmoid colon. Two patients presented with antenatally diagnosed palpable abdominal lump. One had a mesenteric cyst of the ileum and the other had a distal ileal duplication cyst which required excision with resection and anastomosis. One patient had an atypical presentation. He was a known case of sickle cell trait and had presented with vague abdominal pain, recurrent cough and multiple episodes of haemoptysis over a period of one year. At laparotomy, gastric duplication cyst was found which was excised completely. Histopathology confirmed the diagnosis.
Cysts of gastrointestinal origin are rare and have varied presentation. Surgical excision is the mainstay of treatment. The results and prognosis are good.
胃肠道来源的腹部囊肿较为罕见。其罕见性及多样的临床表现使得术前诊断困难。
回顾性分析2009年至2015年间收治的14例经组织学诊断为胃肠道来源囊肿的患者,分析其年龄、性别、临床表现、诊断方式、囊肿部位及类型、治疗方法、结果及随访情况。
患者就诊时的平均年龄为4岁,男性6例,女性8例。腹痛是最常见的就诊症状。5例为急性表现——3例为回肠末端肠系膜囊肿,2例为回肠重复囊肿且与回肠共用一腔壁。6例表现为慢性腹痛及肿块——3例为网膜囊肿,3例为肠系膜囊肿,其中2例位于回肠末端,1例位于乙状结肠。2例产前诊断为可触及的腹部肿块。1例为回肠系膜囊肿,另1例为回肠末端重复囊肿,需行切除及吻合术。1例表现不典型。他是已知的镰状细胞性状病例,在1年时间里出现模糊的腹痛、反复咳嗽及多次咯血。剖腹手术时发现胃重复囊肿并完全切除。组织病理学确诊。
胃肠道来源的囊肿罕见且表现多样。手术切除是主要治疗方法。结果及预后良好。