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儿童十二指肠重复囊肿:临床特征与当前治疗选择

Duodenal Duplication Cysts in Children: Clinical Features and Current Treatment Choices.

作者信息

Dipasquale Valeria, Barraco Paolo, Faraci Simona, Balassone Valerio, De Angelis Paola, Di Matteo Francesco Maria, Dall'Oglio Luigi, Romano Claudio

机构信息

Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood G. Barresi, University Hospital of Messina, Messina, Italy.

Digestive Endoscopy and Surgery Unit, Children's Hospital Bambino Gesù, Rome, Italy.

出版信息

Biomed Hub. 2020 Jul 13;5(2):152-164. doi: 10.1159/000508489. eCollection 2020 May-Aug.

Abstract

BACKGROUND

Duodenal duplication cysts are rare gastrointestinal tract malformations. Most patients experience symptom onset in the first decade of life. This review aims to examine clinical presentation, management strategies and outcomes of duodenal duplication cysts in childhood.

METHODS

A Pubmed/Medline (http://www.ncbi.nlm.nih.gov/pubmed/) search in October 2019 for articles published since 1999 using the keywords "duodenal duplication cyst," "child" and "newborn" was carried out. Clinical symptoms, complications, diagnostic examinations, treatment options and outcomes were analyzed and tabulated.

RESULTS

There were 41 citations in the literature providing adequate descriptions of 45 cases of duodenal duplication cysts. The age of presentation ranged from newborn to 18 years. The median interval between initial presentation and definitive diagnosis and treatment was 17 months (range: 2 months to 12 years). Overall, 67% of cases presented with abdominal pain, and 43% were complicated with pancreatitis. Different surgical and endoscopic therapeutic strategies were reported.

CONCLUSIONS

Duodenal duplication cysts may be associated with life-threatening complications and/or recurrent symptoms, impairing quality of life. Early recognition of patients who demonstrate suggestive signs and symptoms is important to ensure success of treatment. This review may be useful to highlight the main diagnostic aspects and limit the risk of a delayed diagnosis.

摘要

背景

十二指肠重复囊肿是罕见的胃肠道畸形。大多数患者在生命的第一个十年出现症状。本综述旨在探讨儿童十二指肠重复囊肿的临床表现、管理策略及预后。

方法

2019年10月在Pubmed/Medline(http://www.ncbi.nlm.nih.gov/pubmed/)上进行检索,使用关键词“十二指肠重复囊肿”“儿童”和“新生儿”查找自1999年以来发表的文章。对临床症状、并发症、诊断检查、治疗选择及预后进行分析并制成表格。

结果

文献中有41篇引用提供了45例十二指肠重复囊肿的充分描述。发病年龄从新生儿到18岁不等。初次就诊与明确诊断及治疗之间的中位间隔时间为17个月(范围:2个月至12年)。总体而言,67%的病例表现为腹痛,43%并发胰腺炎。报道了不同的手术和内镜治疗策略。

结论

十二指肠重复囊肿可能与危及生命的并发症和/或反复出现的症状相关,影响生活质量。早期识别出现提示性体征和症状的患者对于确保治疗成功很重要。本综述可能有助于突出主要诊断方面并降低延迟诊断的风险。

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