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婴儿回肠末端腔内重复畸形伴异位胃黏膜:肠套叠的罕见病因

Intraluminal Duplication of the Terminal Ileum with Ectopic Gastric Mucosa in an Infant: A Rare Cause of Intussusception.

作者信息

Paradiso Filomena Valentina, Merli Laura, Silvaroli Sara, Fiorentino Vincenzo, Ricci Riccardo, Nanni Lorenzo

机构信息

Division of Pediatric Surgery, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy.

Department of Pathology, Università Cattolica del Sacro Cuore, Largo Vito 1, 00168 Rome, Italy.

出版信息

Case Rep Pediatr. 2020 Jan 27;2020:6898795. doi: 10.1155/2020/6898795. eCollection 2020.

Abstract

Enteric duplication cysts are rare malformations mostly diagnosed before the age of two, with varied clinical presentations. Ectopic gastrointestinal epithelium can be present, and management involves surgical resection. A three-month-old girl presented with rectal bleeding due to an ileocolic intussusception. Abdominal ultrasound revealed a target sign in the right upper part of the abdomen. At hydrostatic contrast enema, an incomplete reduction of the intussusception was obtained: only a trickle of contrast material entered the terminal ileum. An exploratory laparotomy ensued with manual reduction of the intussusception. At the end of the maneuver, a soft intraluminal mass was palpated within the ileocecal valve. Thus, an ileocecal resection was performed. At histology, an intraluminal enteric duplication cyst was documented, containing ectopic gastric mucosa. Secondary intussusception should be suspected even in infants in case of abnormal findings at hydrostatic contrast enema. Intraluminal enteric duplication cysts may be a rare cause of intussusception.

摘要

肠重复囊肿是一种罕见的畸形,大多在两岁前被诊断出来,临床表现多样。可能存在异位胃肠道上皮,治疗方法包括手术切除。一名三个月大的女孩因回结肠套叠出现直肠出血。腹部超声显示腹部右上部分有靶征。在水压灌肠造影时,套叠仅部分复位:只有少量造影剂进入回肠末端。随后进行了剖腹探查术,手动复位套叠。操作结束时,在回盲瓣内摸到一个柔软的腔内肿块。因此,进行了回盲部切除术。组织学检查证实为腔内肠重复囊肿,含有异位胃黏膜。即使在婴儿中,如果水压灌肠造影有异常发现,也应怀疑继发性套叠。腔内肠重复囊肿可能是套叠的罕见原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4901/7007750/f3d79c6c8938/CRIPE2020-6898795.001.jpg

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