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先天性短肠综合征:同一家族中的病例系列及文献综述

Congenital short bowel syndrome: Cases series in the same family and review of literature.

作者信息

Nhan Vu Truong, Hoang Tran Viet, Nhan Pham Nguyen Hien, Huynh Quynh Thi Vu, Ban Ho Tran

机构信息

Department of Pediatric Surgery, Children's Hospital No. 2, Ho Chi Minh City, Viet Nam.

Can Tho University of Medicine and Pharmacy, PhD student of Department of Pediatric Surgery, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam.

出版信息

Int J Surg Case Rep. 2024 Oct;123:110135. doi: 10.1016/j.ijscr.2024.110135. Epub 2024 Aug 22.

Abstract

INTRODUCTION

Congenital short bowel syndrome (CSBS) is a rare congenital gastrointestinal disease and defined as a shortage of consecutive small bowel length present from birth. This syndrome is often accompanied by intestinal malrotation, reduction of peristalsis, and malabsorption.

CASES PRESENTATION

This article reports on siblings carrying the Filamin A (FLNA) genetic mutation with CSBS The first case involved a child admitted to the hospital due to intestinal obstruction, undergoing four surgeries due to intestinal torsion with the remaining length of the small intestine only 60 cm, ultimately resulting in the child's death. The second case is a sibling of the first case, admitted to the hospital due to recurrent abdominal pain, diarrhea, and weight loss. With our previous experience, we conducted genetic testing for the filamin A gene (FLNA), revealing that both siblings and their mothers carried a mutation in the gene.

CLINICAL DISCUSSION

The diagnosis can be indirectly based on the upper gastrointestinal tract contrast study, however, most of diagnoses are confirmed by exploratory surgery. There is no consensus on nutritional treatment guidelines for infants with congenital short-bowel syndrome. Bowel lengthening procedures have not been recommended for infants with CSBS. A lot of disease-causing mutations have been recorded as CXADR-like membrane protein (CLMP) and FLNA.

CONCLUSION

Congenital short bowel syndrome is a rare condition with a poor prognosis. It requires multidisciplinary coordination for effective diagnosis and treatment. Ongoing research into genetic mutations like CLMP and FLNA is vital for understanding CSBS and enhancing patient care.

摘要

引言

先天性短肠综合征(CSBS)是一种罕见的先天性胃肠道疾病,定义为出生时即存在的连续小肠长度短缺。该综合征常伴有肠旋转不良、蠕动减弱和吸收不良。

病例介绍

本文报道了携带丝状肌动蛋白A(FLNA)基因突变的先天性短肠综合征患儿。首例患儿因肠梗阻入院,因肠扭转接受了四次手术,剩余小肠长度仅60厘米,最终导致患儿死亡。第二例是首例患儿的同胞,因反复腹痛、腹泻和体重减轻入院。根据我们之前的经验,我们对丝状肌动蛋白A基因(FLNA)进行了基因检测,发现这对同胞及其母亲均携带该基因的突变。

临床讨论

诊断可间接基于上消化道造影检查,但大多数诊断通过剖腹探查术得以证实。对于先天性短肠综合征婴儿的营养治疗指南尚无共识。对于先天性短肠综合征婴儿,不建议进行肠延长手术。已记录了许多致病突变,如CXADR样膜蛋白(CLMP)和FLNA。

结论

先天性短肠综合征是一种罕见疾病,预后较差。有效诊断和治疗需要多学科协作。对CLMP和FLNA等基因突变的持续研究对于理解先天性短肠综合征和改善患者护理至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9875/11388007/1b55006c9341/gr1.jpg

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