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儿童淋巴瘤相关肠套叠:诊断挑战与临床特征

Lymphoma-related intussusception in children: diagnostic challenges and clinical characteristics.

作者信息

Zhang Rensen, Zhang Minjie, Deng Ruyu, Li Yao, Guo Chunbao

机构信息

Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China.

Department of Pediatrics, Chongqing health center for Women and Children, Chongqing Medical University, 120 Longshan Road, Yubei District, Chongqing, 401147, People's Republic of China.

出版信息

Eur J Pediatr. 2024 Jan;183(1):219-227. doi: 10.1007/s00431-023-05289-2. Epub 2023 Oct 20.

Abstract

UNLABELLED

Intussusception is a common cause of acute abdominal pain in children and the most frequent cause of intestinal obstruction in infants. Although often idiopathic, it can stem from conditions like lymphoma. This study delves into lymphoma-related intussusception in children, aiming to enhance early detection and management. A retrospective review encompassed children admitted from 2012 to 2023 with intussusception due to intestinal lymphoma. Demographic, clinical, and imaging data were meticulously extracted and analyzed. The study included 31 children in the lymphoma-related intussusception group. Contrasted with non-lymphoma-related cases, the patients of lymphoma-related intussusception were notably older (median age: 87 months vs. 18.5 months), predominantly male, and demonstrated protracted abdominal pain. Ultrasound unveiled mesenteric lymph node enlargement and distinct intra-abdominal masses; enema reduction success rates were notably diminished. Detecting lymphoma-related intussusception remains intricate. Age, prolonged symptoms, and distinctive ultrasound findings can arouse suspicion. Timely surgical intervention, based on preoperative imaging, proves pivotal for accurate diagnosis.

CONCLUSION

Swift identification of lymphoma-related intussusception, distinguished by unique clinical and ultrasound features, is imperative for timely intervention and treatment. Further research is warranted to refine diagnostic approaches.

WHAT IS KNOWN

• Intussusception in pediatric patients can be caused by a wide spectrum of underlying diseases including lymphoma. • Early Identifying the exact underlying cause of intussusception is crucial for tailored therapy, however often challenging and time-consuming.

WHAT IS NEW

• Lymphoma-related intussusception may present with increased abdominal fluid accumulation, intestinal obstruction, and a higher likelihood of failed reduction during enema procedures. • For high-risk children, repeated ultrasound examinations or further investigations may be necessary to confirm the diagnosis.

摘要

未标注

肠套叠是儿童急性腹痛的常见原因,也是婴儿肠梗阻最常见的原因。虽然通常为特发性,但它可能源于淋巴瘤等疾病。本研究深入探讨儿童淋巴瘤相关肠套叠,旨在加强早期检测和管理。一项回顾性研究纳入了2012年至2023年因肠道淋巴瘤导致肠套叠而入院的儿童。精心提取并分析了人口统计学、临床和影像学数据。淋巴瘤相关肠套叠组包括31名儿童。与非淋巴瘤相关病例相比,淋巴瘤相关肠套叠患者年龄明显较大(中位年龄:87个月对18.5个月),以男性为主,并表现出持续性腹痛。超声显示肠系膜淋巴结肿大和明显的腹腔内肿块;灌肠复位成功率明显降低。检测淋巴瘤相关肠套叠仍然很复杂。年龄、症状持续时间和独特的超声表现可能会引起怀疑。基于术前影像学的及时手术干预对准确诊断至关重要。

结论

迅速识别具有独特临床和超声特征的淋巴瘤相关肠套叠,对于及时干预和治疗至关重要。有必要进一步研究以完善诊断方法。

已知信息

• 小儿患者的肠套叠可由包括淋巴瘤在内的多种潜在疾病引起。• 早期确定肠套叠的确切潜在原因对于量身定制治疗至关重要,但往往具有挑战性且耗时。

新发现

• 淋巴瘤相关肠套叠可能表现为腹腔积液增加、肠梗阻以及灌肠过程中复位失败的可能性更高。• 对于高危儿童,可能需要重复超声检查或进一步检查以确诊。

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