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盲肠重复囊肿与梅克尔憩室并存致营养不良儿童肠套叠:一例报告并文献复习

Coexistence of cecal duplication cyst and Meckel's diverticulum presenting as intussusception in a malnourished child a case report with literature review.

作者信息

Hakimi Turyalai, Aslamzai Mansoor, Seyar Farukh, Hakimi Zamaryalai, Halimi Sultan Ahmad, Jawed Mohammad Anwar

机构信息

Department of Pediatric Surgery, Kabul University of Medical Science, Maiwand Teaching Hospital, Kabul, Afghanistan.

Department of Neonatology, Kabul University of Medical Science, Maiwand Teaching Hospital, Kabul, Afghanistan.

出版信息

BMC Pediatr. 2025 Jul 1;25(1):479. doi: 10.1186/s12887-025-05823-1.

Abstract

Alimentary tract duplications, or enterocystomas, are relatively uncommon developmental anomalies that can occur anywhere from the mouth to the anus. One-third of these enteric duplications present within the neonatal period, while the remaining two-thirds appear within the first two years of life. However, some cases may manifest in later childhood or even adulthood. The diagnosis is often incidental, though patients may present with abdominal pain or obstructive symptoms. In certain cases, these lesions can serve as leading points for intussusception in children, which is a common cause of emergency surgical admission in pediatric surgical units. We present the case of a 15-month-old male child who was admitted to our pediatric surgery unit with acute intestinal obstruction due to intussusception. Clinical evaluation and ultrasonography confirmed the diagnosis of bowel obstruction secondary to intussusception. During surgery, the intussusception was found to involve the distal ileum, cecum, ascending colon, and extended through the transverse colon down to the rectum. A cystic mass in the cecum, identified as the lead point, was observed causing the bowel segments to telescope into one another, with the intussuscepted segment protruding through the anal canal. All affected bowel segments were carefully reduced, revealing a cystic mass in the proximal cecum serving as the lead point for intussusception. A Meckel's diverticulum was also identified at a distinct site in the ileum, proximal to the location of the intussusception. A right hemicolectomy and Meckel's diverticulectomy were performed, followed by the creation of a diverting loop ileostomy. Histopathological examination confirmed the lesion to be a duplicated cyst. The postoperative course was uneventful. This report highlights a rare coexistence of cecal duplication cyst and Meckel's diverticulum causing intussusception, a combination scarcely reported in pediatric surgical emergencies.

摘要

消化道重复畸形,即肠囊肿,是相对罕见的发育异常,可发生于从口腔到肛门的任何部位。其中三分之一的肠道重复畸形在新生儿期出现,其余三分之二则在生命的头两年出现。然而,有些病例可能在儿童期后期甚至成年期才表现出来。诊断通常是偶然发现的,不过患者可能会出现腹痛或梗阻症状。在某些情况下,这些病变可成为儿童肠套叠的起始点,这是小儿外科病房急诊手术入院的常见原因。我们报告一例15个月大的男童,因肠套叠导致急性肠梗阻入住我们的小儿外科病房。临床评估和超声检查证实了肠套叠继发肠梗阻的诊断。手术中发现肠套叠累及回肠末端、盲肠、升结肠,并延伸至横结肠直至直肠。观察到盲肠内有一个囊性肿物,被确定为起始点,导致肠段相互套叠,套叠的肠段经肛管突出。所有受累肠段均仔细复位,发现近端盲肠有一个囊性肿物作为肠套叠的起始点。在回肠套叠部位近端的一个不同位置还发现了一个梅克尔憩室。进行了右半结肠切除术和梅克尔憩室切除术,随后做了一个转流性回肠造口术。组织病理学检查证实病变为重复囊肿。术后过程顺利。本报告强调了盲肠重复囊肿和梅克尔憩室罕见地并存导致肠套叠,这种情况在小儿外科急诊中鲜有报道。

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