Xiang Li, Lan Jiaming, Chen Bailin, Li Ping, Guo Chunbao
Department of Pediatric General Surgery.
Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital, Chongqing Medical University, Chongqing.
Medicine (Baltimore). 2019 Nov;98(44):e17682. doi: 10.1097/MD.0000000000017682.
Due to the various presentations of gastrointestinal tract duplications (GTD), diagnosing and management for this disease might be varied and difficult. We intend to improve the experiences for these difficult, in terms of the clinical presentations, diagnostic investigations, management.We reviewed recent literature and retrospectively analyzed 72 pediatric patients with enteric duplication. Diagnosis was confirmed by surgery and pathological examination for imaging characteristics and clinical and pathological features.The ages of patients ranged from one month to 12.5 years. The clinical presentations of the patients included 57 cases with abdominal pain, followed with nausea or vomiting, abdominal distension, etc. All of the patients were diagnosed by ultrasonography, and most of them presented as intra-abdominal cystic masses. Four cases were diagnosed with the cysts other than GTDs, like, mesenteric cyst, chledochal cyst and abscess, and so on. Computed tomography was performed on 65 patients. X-rays and barium meal showed the outline of the cyst structure, with intestinal displacement due to the pressure from the cyst. Among the 72 cases of enteric duplication, 45 were located with ileocecal area, 41 were ileal and 8 were colonic duplications.Enteric duplication is very rare in children and is prone to misdiagnosis. The preoperative diagnosis of enteric duplication can be improved through comprehensive analysis of various imaging exams and closely related clinical presentations.
由于胃肠道重复畸形(GTD)的表现多样,该病的诊断和治疗可能存在差异且具有挑战性。我们旨在从临床表现、诊断检查、治疗等方面改善对这些疑难病症的诊治经验。我们回顾了近期文献,并对72例小儿肠重复畸形患者进行了回顾性分析。通过手术及病理检查,依据影像学特征以及临床和病理特征确诊。患者年龄从1个月至12.5岁不等。患者的临床表现包括57例腹痛,随后伴有恶心或呕吐、腹胀等。所有患者均通过超声检查确诊,大多数表现为腹腔内囊性肿块。4例被诊断为非GTD的囊肿,如肠系膜囊肿、胆总管囊肿和脓肿等。65例患者进行了计算机断层扫描。X线和钡餐显示了囊肿结构的轮廓,由于囊肿的压迫导致肠管移位。在72例肠重复畸形病例中,45例位于回盲部,41例为回肠重复畸形,8例为结肠重复畸形。肠重复畸形在儿童中非常罕见,且容易误诊。通过综合分析各种影像学检查和密切相关的临床表现,可以提高肠重复畸形的术前诊断率。