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儿童结肠憩室炎:16 例回顾性研究。

Colonic diverticulitis in children: A retrospective study of 16 patients.

机构信息

Department of Pediatric Surgery, Japanese Red Cross Society Himeji Hospital, Himeji, Japan.

Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

出版信息

Pediatr Int. 2021 Dec;63(12):1510-1513. doi: 10.1111/ped.14693. Epub 2021 Oct 4.

Abstract

BACKGROUND

Pediatric colonic diverticulitis (CD) is a rare entity. This study aimed to investigate the clinical features of CD in children.

METHODS

We performed a retrospective chart review of children aged ≤15 years who were diagnosed with CD in our institution from May 2006 to November 2016.

RESULTS

Sixteen patients were diagnosed with CD. All CD cases were observed to be solitary cecal diverticulitis; 14 cases were detected using ultrasound and the other two cases were diagnosed by computed tomography. Five patients were male (31.3%), and the median age was 12 years (range, 8-15 years). Initial symptoms were fever (temperature >38°C) in six (37.5%) patients, right lower quadrant abdominal pain in 16 (100%), anorexia in eight (50%), and nausea / vomiting in five (31.3%). A patient experienced persistent constipation; however, diarrhea was not observed as a clinical symptom in any patient. The median duration from symptom onset to admission was 1 day (range, 0-4 days), and the median length of hospital stay was 6 days (range, 4-10 days). All CD cases were treated with intravenous antibiotics. The median follow-up period was 90 months (range, 37-163 months), and during this period, recurrence of CD was observed in three (18.8%) patients. At recurrence, antibiotics were administered in all cases.

CONCLUSIONS

In this study, all cases of CD were solitary cecal diverticulitis, and ultrasound was useful for the diagnosis of cecal diverticulitis in children. Non-operative treatment should be recommended as an initial treatment for CD in children.

摘要

背景

小儿结肠憩室炎(CD)是一种罕见疾病。本研究旨在探讨儿童 CD 的临床特征。

方法

我们对 2006 年 5 月至 2016 年 11 月在我院诊断为 CD 的≤15 岁儿童进行了回顾性病历分析。

结果

共诊断出 16 例 CD 患儿。所有 CD 病例均为单纯性盲肠憩室炎;14 例经超声检查发现,另 2 例经 CT 诊断。5 例为男性(31.3%),中位年龄为 12 岁(范围,8-15 岁)。首发症状为发热(体温>38°C)6 例(37.5%),右下腹腹痛 16 例(100%),食欲不振 8 例(50%),恶心/呕吐 5 例(31.3%)。1 例患者出现持续便秘;但无腹泻症状。症状出现至入院中位时间为 1 天(范围,0-4 天),中位住院时间为 6 天(范围,4-10 天)。所有 CD 病例均采用静脉抗生素治疗。中位随访时间为 90 个月(范围,37-163 个月),期间 3 例(18.8%)患者 CD 复发。复发时,所有病例均采用抗生素治疗。

结论

本研究中,所有 CD 病例均为单纯性盲肠憩室炎,超声对儿童盲肠憩室炎的诊断具有重要价值。非手术治疗应作为儿童 CD 的初始治疗方法。

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