Lombardi P, Nincheri Kunz M, Giovane A, Renzi F, Borrelli A, Kröning K C, Prosperi P, Bencini L, Catarzi S
Clinica Chirurgica (Direttore: Prof. G. Allegra), Università degli Studi, Firenze.
Minerva Chir. 1998 Jan-Feb;53(1-2):83-8.
The report presents a rare case of intestinal duplication in a 43-year old female. Intestinal duplication is a rare congenital malformation and is extremely exceptional in adults. A lot of etiopathogenic theories have been advanced to explain this malformation that can occur anywhere along the alimentary tract, even if the ileum remains the most common. It may be cystic or tubular. An important aspect of mucosal histology is the possibility of gastric heterotopy, conditioning a particular treatment. The literature shows 14 cases with clinical very different presentations and instrumental exams were rarely helpful for correct diagnosis. Treatment of choice is surgical complete resection of the duplication. When contiguous structures are involved intestinal bypass or Roux-on-Y anastomosis may be necessary with mandatory stripping of the mucosa when heterotopic gastric mucosa is present in order to prevent the risk of gastrointestinal haemorrhage or malignant transformation, an event possible in about 25% of the cases reported in the literature.
该报告介绍了一例43岁女性罕见的肠道重复畸形病例。肠道重复畸形是一种罕见的先天性畸形,在成年人中极为罕见。为解释这种可发生于消化道任何部位的畸形,已提出许多病因学理论,尽管回肠仍是最常见的发病部位。它可能是囊性或管状的。黏膜组织学的一个重要方面是存在胃异位的可能性,这决定了特殊的治疗方法。文献显示有14例临床表现差异很大的病例,而影像学检查对正确诊断很少有帮助。首选的治疗方法是手术完整切除重复畸形。当累及相邻结构时,可能需要进行肠道旁路手术或Roux-en-Y吻合术,若存在异位胃黏膜则必须剥除黏膜,以防止胃肠道出血或恶性转化的风险,文献报道的病例中约25%可能发生这种情况。