Delarue A, Garcia-Meric P, Martin C, Piguet C, André N, Galli G, Guys J M
Fédération de Chirurgie Pédiatrique, Hôpital Timone-Enfants, Marseille, France.
Pediatr Surg Int. 1998 Apr;13(4):288-9. doi: 10.1007/s003830050319.
A cystic pelvic malformation was found in a fetus on antenatal sonography (US) at 26 weeks of gestational age that was no longer present 3 weeks later on control US. The male child presented at birth with a right-sided perineal mass that fistulized with meconial drainage. A radiopaque enema showed a low posterior rectal fistula filling a poorly delineated pouch. Surgery performed through a posterior sagittal approach allowed identification and closure of the fistula and pouch drainage. The diagnosis of a diverticular rectal duplication was considered, although no intestinal lining was observed macroscopically or histologically. The child's anorectal function was normal after a 20-month follow-up. Labeling of the malformation and embryological hypotheses are discussed since the case does not fulfill all the criteria of an intestinal duplication. Surgical techniques are discussed, with an emphasis on the sagittal posterior approach.
一名孕26周胎儿经产前超声检查发现盆腔有一囊性畸形，3周后的复查超声显示该畸形已不复存在。该男婴出生时右侧会阴有一肿物，伴有胎粪引流瘘管形成。造影灌肠显示低位直肠后瘘，瘘管通向一个边界不清的囊袋。经后矢状入路手术成功识别并闭合了瘘管，对囊袋进行了引流。尽管在大体和组织学上均未观察到肠黏膜，但仍考虑诊断为憩室型直肠重复畸形。经过20个月的随访，患儿的肛门直肠功能正常。鉴于该病例并不完全符合肠重复畸形的所有标准，本文讨论了该畸形的命名及胚胎学假说。文中还讨论了手术技术，重点是后矢状入路。
