Wang DengLiang, Kang Quan, Shi ShuJun, Hu Wei
Department of Hepatobiliary Surgery, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, 400014, China.
Pediatr Surg Int. 2018 Aug;34(8):823-827. doi: 10.1007/s00383-018-4299-0. Epub 2018 Jun 16.
To summarize the clinical characteristics, diagnosis, treatment and prognosis among 152 children with annular pancreas (AP). A retrospective review of 152 patients with AP who were treated with surgical repair between January 2009 and August 2017 was performed at our pediatric surgical units. Presenting symptoms, birth weight, radiological findings, associated anomalies, the type of surgery performed were analyzed. (1) 152 patients were identified, out of which 82 were males, and 70 were females; (2) the average birth weight of children with AP was less than that of healthy newborns. The birth weights of 5.4% premature infants were less than 1500 g; the birth weight of 17% full-term infants, 69% premature infants and 50% post-term infants were less than 2500 g. (3) 100 (66%) patients presented symptoms during neonatal period and 43 (28%) patients had duodenal obstruction diagnosed by prenatal ultrasound scan. (4) All cases were managed surgically by open laparotomy, and all patients were duly discharged. AP most commonly presents symptoms in early neonatal period. Infants with AP are associated with a higher rate of low birth weight, and it was because swallowed amniotic fluid could not be absorbed and impaired insulin secretion caused by abnormal pancreas. Ultrasonography, abdominal plain film and upper gastrointestinal series (UGI) are helpful, but cannot make the diagnosis, and surgery is the only effective way to diagnose and treat AP.
总结152例环状胰腺（AP）患儿的临床特征、诊断、治疗及预后情况。对2009年1月至2017年8月间在我院小儿外科接受手术修复治疗的152例AP患儿进行回顾性分析。分析其临床表现、出生体重、影像学检查结果、合并畸形以及所施行的手术类型。（1）共纳入152例患儿，其中男性82例，女性70例；（2）AP患儿的平均出生体重低于健康新生儿。5.4%的早产儿出生体重低于1500g；17%的足月儿、69%的早产儿及50%的过期产儿出生体重低于2500g。（3）100例（66%）患儿在新生儿期出现症状，43例（28%）患儿经产前超声检查诊断为十二指肠梗阻。（4）所有病例均通过开腹手术治疗，所有患儿均顺利出院。AP最常在新生儿早期出现症状。AP患儿低出生体重发生率较高，这是因为吞咽的羊水无法吸收以及胰腺异常导致胰岛素分泌受损。超声检查、腹部平片及上消化道造影（UGI）有一定帮助，但不能确诊，手术是诊断和治疗AP的唯一有效方法。
