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小儿结肠腺癌:一例误诊为肠胃炎和便秘的病例

Pediatric colonic adenocarcinoma: A deceptive case of gastroenteritis and constipation.

作者信息

Hachem Jack J, Javadi Sara, McKee Milissa, Noel James, Noel Robert A

机构信息

Department of Pediatric Gastroenterology, Baylor College of Medicine Children's Hospital of San Antonio San Antonio Texas USA.

Department of Pediatric Gastroenterology Baylor College of Medicine Houston Texas USA.

出版信息

JPGN Rep. 2024 May 15;5(3):371-373. doi: 10.1002/jpr3.12080. eCollection 2024 Aug.

Abstract

Adenocarcinoma of the colon is a rare diagnosis in pediatric patients. We present a previously healthy 15-year-old female who began experiencing escalating colicky abdominal pain and associated vomiting over 2 weeks in the setting of presumed acute gastroenteritis. A computed tomography scan revealed an obstruction in her descending colon. A multidisciplinary decision was made to perform a colonoscopy upon which a large, circumferential, friable lesion was discovered 40 cm from the anus. A colon decompression catheter was successfully inserted following controlled radial expansion (CRE) Balloon dilation to 13.5 mm beyond the mass, resulting in a significant discharge of fluid and gas. The patient underwent hemicolectomy with mass resection and colostomy. Biopsies confirmed poorly differentiated adenocarcinoma with "napkin-ring" morphology and positive lymph node metastasis with extranodal extension.

摘要

结肠腺癌在儿科患者中是一种罕见的诊断。我们报告一名此前健康的15岁女性,在假定为急性胃肠炎的情况下,她在2周内开始出现逐渐加重的绞痛性腹痛并伴有呕吐。计算机断层扫描显示她的降结肠有梗阻。经过多学科讨论后决定进行结肠镜检查,结果在距肛门40厘米处发现一个大的、环形的、易碎的病变。在通过可控径向扩张(CRE)球囊扩张至肿块上方13.5毫米后,成功插入了一根结肠减压导管,大量液体和气体排出。患者接受了半结肠切除术,包括肿块切除和结肠造口术。活检证实为低分化腺癌,具有“餐巾环”形态,伴有阳性淋巴结转移及结外浸润。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c640/11322021/b2dbf5d1cbff/JPR3-5-371-g001.jpg

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