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儿童急腹症罕见盲肠病变病因。

Rare cecum pathologies as a cause of acute abdomen in children.

机构信息

Department of Pediatric Surgery, Mehmet Akif İnan Training and Research Hospital, Şanlıurfa-Turkey.

Department of Pediatric Surgery, ŞanlıurfaTraining and Research Hospital, Şanlıurfa-Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2022 Mar;28(3):249-253. doi: 10.14744/tjtes.2020.79357.

DOI:10.14744/tjtes.2020.79357
PMID:35485572
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10493532/
Abstract

BACKGROUND

We aimed to present cecum pathologies which are the cause of acute abdomen.

METHODS

Between January 2015 and June 2019, patients that were operated with the diagnosis of acute abdomen and patients with the primary cecum pathologies were evaluated retrospectively.

RESULTS

There were eight patients, five males and three females. The mean age was 7.2±2.9 years. Complaints were abdominal pain and vomiting in all patients. Physical examination was consistent with acute abdomen. In the imaging studies, the preliminary diagnosis was considered as two patients had acute appendicitis, two had invagination (one due to Meckel diverticulum and one with mesenteric cyst), two had ileus, one had perforated appendicitis, and one had cecum diverticulum. In surgery, five patients had cecum mass, one had cecum diverticulitis, one had cecum volvulus, and one had inflamed necrotic cecum. All patients underwent cecum resection and ileocolonic anastomosis. Histopathologic examination was resulted as Burkitt's lymphoma in three patients, cecum diverticulum in two, duplication of cecum in one, tuberculosis of cecum in one, and gangrenous necrosis due to volvulus in one patient. The mean follow-up period was 25 months (2 months-4 years). Follow-up was uneventful.

CONCLUSION

Primary cecum pathologies are very rare. This leads to lack of standardization in treatment planning. Considering the patients with malignancy in the series, ileocolonic anastomosis with cecum resection is an adequate and appropriate treatment option in children with primary cecum pathology.

摘要

背景

本研究旨在阐述导致急腹症的盲肠病变。

方法

回顾性分析 2015 年 1 月至 2019 年 6 月期间以急腹症行手术治疗且原发病灶位于盲肠的患者。

结果

共有 8 例患者,男 5 例,女 3 例,平均年龄 7.2±2.9 岁。所有患者均表现为腹痛、呕吐。体格检查均符合急腹症表现。影像学检查初步诊断为急性阑尾炎 2 例,肠套叠 2 例(1 例由 Meckel 憩室引起,1 例伴肠系膜囊肿),肠梗阻 2 例,穿孔性阑尾炎 1 例,盲肠憩室 1 例。手术中,5 例患者发现盲肠肿块,1 例盲肠憩室炎,1 例盲肠扭转,1 例盲肠炎症伴坏死。所有患者均接受了盲肠切除术和回结肠吻合术。病理检查结果为 Burkitt 淋巴瘤 3 例,盲肠憩室 2 例,盲肠重复畸形 1 例,盲肠结核 1 例,盲肠扭转导致的坏疽性坏死 1 例。平均随访时间为 25 个月(2 个月-4 年)。随访期间无不良事件发生。

结论

盲肠原发性疾病非常罕见,导致治疗方案缺乏标准化。考虑到本研究系列中存在恶性肿瘤患者,对于盲肠原发性疾病患儿,盲肠切除加回肠结肠吻合术是一种充分且合适的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccbf/10493532/54469f447aa6/TJTES-28-249-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccbf/10493532/ea217e389a99/TJTES-28-249-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccbf/10493532/8c328cb78e47/TJTES-28-249-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccbf/10493532/c0c93ff12b0e/TJTES-28-249-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccbf/10493532/8bd85aa39cb6/TJTES-28-249-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccbf/10493532/54469f447aa6/TJTES-28-249-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccbf/10493532/ea217e389a99/TJTES-28-249-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccbf/10493532/8c328cb78e47/TJTES-28-249-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccbf/10493532/c0c93ff12b0e/TJTES-28-249-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccbf/10493532/8bd85aa39cb6/TJTES-28-249-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccbf/10493532/54469f447aa6/TJTES-28-249-g005.jpg

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Surgery for Abdominal Tuberculosis in the Present Era: Experience from a Tertiary-Care Center.当代腹部结核的外科治疗:来自三级医疗中心的经验
Surg Infect (Larchmt). 2018 Aug/Sep;19(6):640-645. doi: 10.1089/sur.2018.077. Epub 2018 Jul 25.
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Cecal duplication: A mimicker of intussusception: A case report and review.盲肠重复畸形:肠套叠的模仿者:一例报告及文献复习
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Intraoperative diagnosis of cecal diverticulitis during surgery for acute appendicitis: Case series.急性阑尾炎手术中盲肠憩室炎的术中诊断:病例系列
Ulus Cerrahi Derg. 2015 Jun 24;32(1):54-7. doi: 10.5152/UCD.2015.2765. eCollection 2016.
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Cecocolic intussusception in a patient with a cecal duplication cyst.一名患有盲肠重复囊肿的患者发生了盲结肠套叠。
Turk J Gastroenterol. 2015 May;26(3):281-2. doi: 10.5152/tjg.2015.0072.
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