儿童消化系重复畸形诊治19例

Treatment of digestive duplication in children:Our experience with 19 cases

目的:探讨消化系重复畸形患儿的临床特点、病理特点、诊断方法、治疗方法及效果.方法:回顾性分析我院1995-04/2012-08门诊诊断及住院治疗的19例经手术病理证实的消化系重复畸形患儿的临床资料,该组患儿均经超声诊断,12例行CT检查.全部经手术治疗.结果:19例患儿临床多表现为肠梗阻、腹膜炎、出血以及腹块.经超声检查均发现腹部囊性肿物,其中7例有典型的声像图表现,呈现为大小不等的厚壁囊性团块,囊壁的边界清晰,肠壁呈"强-弱-强"3层结构特点.病变主要位于小肠,有14例,占73.68%.病变形态主要为囊肿型14例,占73.68%.所有患儿经手术治疗后死亡1例,死亡率为5.2%.其余患儿随访3mo-15年,生长发育正常.结论:超声诊断消化系重复畸形的特异性强,方法简便,无放射性,手术切除是治疗消化系重复畸形的最好选择.

AIM： To summarize the clinical features, pathol- ogy, diagnosis and treatment of digestive dupli- cation in children. METHODS： Clinical data for 19 children with pathologically confirmed digestive duplication, who were treated at our hospital from April 1995 to August 2012, were analyzed retrospec- tively. All patients underwent ultrasound, and 12 patients received CT. All patients underwent surgical treatment. RESULTS： Main clinical manifestations included intestinal obstruction, peritonitis, bleeding and abdominal mass. A cystic mass was found in the abdomen by ultrasound in all patients. Seven cases had typical sonographic manifestations, including thick wall of the cys- tic mass, a clear boundary of the cystic wall, and a three-layer structure （＂strong - weak - strong＂） of the intestinal wall. The majority （73.68%） of lesions were located in the small intestine. Cyst was the main form of lesions, accounting for 73.68% of all cases. One child died after surgery, and the mortality rate was 5.2%. The remaing, patients were followed for 3 mo to 15 years, and their growth and de- velopment were normal. CONCLUSION： Ultrasound is a simple, specific, non-radioactive method for the diagnosis of gas- trointestinal duplication, and surgical resection is the best choice of treatment.