小儿肠系膜乳糜囊肿五例诊治分析

Clinical analysis of chylous mesenteric cysts in children

目的 探讨小儿肠系膜乳糜囊肿的临床特点、诊断及治疗方法.方法 回顾性分析2005～2015年间收治的5例小儿肠系膜乳糜囊肿患儿的临床表现及治疗经过.本组男孩3例,女孩2例,年龄2～10岁,中位年龄4岁2个月,病程1d至2年.2例表现为急腹症,术中证实囊肿压迫肠管并发肠梗阻.3例行单纯囊肿切除,2例行囊肿及受累肠管切除肠吻合.结果 全部病例行手术治疗,囊内液均呈乳糜状.术后肠道功能恢复正常,原有症状消失,痊愈出院.随访6个月至5年未见明显异常,腹部B超检查未见囊肿复发.结论 小儿肠系膜乳糜囊肿的主要临床表现为腹部肿块、腹胀,部分患儿以急腹症为首发症状,临床表现与囊肿位置相关.完整地手术切除囊肿及受累肠管预后良好.

Objective To evaluate the clinical features, diagnosis, and treatment of chylous mesenteric cysts （CMCs） in children. Methods Between 2005 and 2015, 5 children with CiVICs were admitted in this institution and the clinical data were analyzed retrospectively. Results This series comprised 2 girls and 3 boys. Age ranged from 2 years to 10 years with a median age of 4 years and 2 months. The duration from onset to admission ranged from 1 day to 2 years. Two cases presented as acute abdomen with intestinal compression by the cyst. Resection of mesenteric cyst and involved in- testinal segment with primary anastomosis was performed on 2 cases and resection of cyst only on the rest 3. Chyle was found within all the cysts. Conclusions CIVICs manifest as an abdominal mass and abdominal distention, and acute abdomen could be a usual primary presentation. The clinical presenta- tion suggests some association with the localization of the cysts. A good prognosis can be expected with removal of the cyst and the affected intestinal segment.