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儿童胸腹重复畸形:两例报告

Thoraco-abdominal duplications in children: Two case reports.

作者信息

Thamri Fatma, Sahli Sondes, Houidi Senda, Aziza Bochra, Jouini Riadh

机构信息

Department of Pediatric Surgery "A", Children's Hospital of Tunis, University of Tunis El Manar, 13 Rue Jbel Lakhdhar, Beb Saadoun, Tunis 1029, Tunisia.

Department of Pediatric Surgery "A", Children's Hospital of Tunis, University of Tunis El Manar, 13 Rue Jbel Lakhdhar, Beb Saadoun, Tunis 1029, Tunisia.

出版信息

Int J Surg Case Rep. 2021 Dec;89:106651. doi: 10.1016/j.ijscr.2021.106651. Epub 2021 Dec 4.

Abstract

INTRODUCTION

Thoraco-abdominal duplication is rare congenital malformations of the notochord that occurs in only 2% of cases of alimentary tract duplications. We report two rare cases of thoraco-abdominal duplication, emphasizing the value of radiological assessment and discussing the place of diagnostic and therapeutic laparoscopy.

PRESENTATION OF CASE

It was a 12-year-old girl and an 8-month-old boy, admitted for epigastralgia and dysphagia with respiratory distress respectively. Imaging was in favor of pancreatic duplication with intra-thoracic extension for the first patient and gastro-esophageal duplication for the second. A mass excision was done laparoscopically for the first and by a thoracotomy for the second. The aftermath of the surgery was simple in both cases.

CLINICAL DISCUSSION

Thoraco-abdominal duplications are rare congenital malformations that account for only 2% of cases of gastrointestinal duplications. Their diagnosis is difficult since the revealing symptomatology is not common. The treatment is only surgical is facilitated by the laparoscopy which has a diagnostic and therapeutic interest.

CONCLUSION

Our case reports focused on the difficulty of the diagnosis that is done by imaging and is confirmed by surgery with anatomopathological examination of the excised mass. Diagnostic and therapeutic minimally invasive approach should be used whenever possible.

摘要

引言

胸腹重复畸形是脊索罕见的先天性畸形,仅占消化道重复畸形病例的2%。我们报告两例罕见的胸腹重复畸形病例,强调放射学评估的价值并讨论诊断性和治疗性腹腔镜检查的作用。

病例介绍

一名12岁女孩和一名8个月大男孩分别因上腹部疼痛和吞咽困难伴呼吸窘迫入院。影像学检查显示,首例患者为胰腺重复畸形并向胸腔内延伸,第二例为胃食管重复畸形。首例患者通过腹腔镜进行了肿块切除,第二例通过开胸手术进行了切除。两例患者术后恢复均顺利。

临床讨论

胸腹重复畸形是罕见的先天性畸形,仅占胃肠道重复畸形病例的2%。由于首发症状不常见,其诊断较为困难。治疗仅为手术治疗,腹腔镜检查有助于手术进行,兼具诊断和治疗意义。

结论

我们的病例报告聚焦于通过影像学检查进行诊断的困难,手术切除肿块的解剖病理学检查证实了诊断。应尽可能采用诊断性和治疗性微创方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca67/8665331/7e7a4c90b654/gr1.jpg

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