儿童回肠Burkitt淋巴瘤并发回回结型肠套叠一例

Ileal Burkitt lymphoma complicated with ileoilecolic intussusception: a case report

儿童继发性肠套叠常易被误诊,该文报道1例Burkitt淋巴瘤并发回回结型肠套叠女性患儿,其因反复腹痛1个月,伴腹胀1周入院,初诊医师考虑为胃肠炎,予相关治疗后无效。其后行腹部B超检查,提示为肠套叠,行空气灌肠治疗不成功。患儿有明确的剖腹探查指征,遂急诊行剖腹探查术,逐步复位套叠肠管,发现末端回肠肿物,术中诊断为:1回回结型肠套叠;2末端回肠肿物,行末端回肠部分切除吻合+阑尾切除术,将切除的肿物及末端回肠送病理活组织检查,结果显示为Burkitt淋巴瘤。术后6 d患儿食欲佳,其后再接受化学治疗。经治疗后患儿情况稳定,脑脊液、腹部彩色多普勒超声检查及CT等均未见新发病灶。

It is likely to make a misdiagnosis of pediatric intussusception. Here,we reported one female child of Burkitt lymphoma complicated with ileoilecolic intussusception. She was admitted to our hospital due to recurrent abdominal pain for one month and abdominal distension for one week. She was initially diagnosed with gastroenteritis and untreated after clinical therapy. Abdominal B ultrasound hinted the sign of intussusception and air enema therapy was failure. She presented with definite surgical indications of abdominal exploration and underwent abdominal exploration in emergency department. Intraoperatively,ileoilecolic intussusception was treated and terminal ileal tumor was identified. She was diagnosed with ileoilecolic intussusception complicated with terminal ileal tumor. She underwent partial resection and anastomosis of the terminal ileum.The resected tumor and terminal ileum samples were prepared for pathological evaluation. She was pathologically diagnosed with Burkitt lymphoma. She restored normal diet at 6 d after surgery and then received chemotherapy. The patient remained physically stable. Cerebrospinal fluid,abdominal color doppler ultrasound and CT scan revealed no new lesions.