BACKGROUND Duodenal duplications are rare congenital anomalies of the gastrointestinal tract.As the periampullary variant is much rarer,literature is scant and only few authors have reported their experience in diagno...BACKGROUND Duodenal duplications are rare congenital anomalies of the gastrointestinal tract.As the periampullary variant is much rarer,literature is scant and only few authors have reported their experience in diagnosis and treatment,particularly with operative endoscopy.CASE SUMARY To report our experience with the endoscopic treatment in a series of children with periampullary duodenal duplication cysts,focusing on the importance of obtaining an accurate preoperative anatomic assessment of the malformations.The pediatric periampullary duodenal duplication cyst literature is reviewed.We conducted a systematic review according to the PRISMA guidelines.The PubMed database was searched for original studies on“duodenal duplication”,“periampullary duplication”or“endoscopic management”published since 1990,involving patients younger than 18 years of age.Eligible study designs were case report,case series and reviews.We analyzed the data and reported the results in table and text.Fifteen eligible articles met the inclusion criteria with 16 patients,and analysis was extended to our additional 4 cases.Median age at diagnosis was 13.5 years.Endoscopic treatment was performed in 10(50%)patients,with only 2 registered complications.CONCLUSION Periampullary duodenal duplication cysts in pediatric patients are very rare.Our experience suggests that an accurate preoperative assessment is critical.In the presence of sludge or stones inside the duplication,endoscopic retrograde cholangio-pancreatography is mandatory to demonstrate a communication with the biliary tree.Endoscopic treatment resulted in a safe,minimally invasive and effective treatment.In periampullary duodenal duplication cyst endoscopically treated children,long-term follow-up is still necessary considering the potential malignant transformation at the duplication site.展开更多
Sigmoid volvulus(SV)is extremely uncommon in children and is usually associated with a long-standing history of constipation or pseudo-obstruction.An early diagnosis and management are crucial in order to prevent the ...Sigmoid volvulus(SV)is extremely uncommon in children and is usually associated with a long-standing history of constipation or pseudo-obstruction.An early diagnosis and management are crucial in order to prevent the appearance of hemorrhagic infarction of the twisted loop,avoiding further complications such as necrosis,perforation and sepsis.In patients with no evidence of peritonitis or ischemic bowel,treatment starts with resuscitation and detorsion of the SV,accomplished by means of sigmoidoscopy and concomitant rectal tube placement.The bowel is then prepared and surgery is undertaken electively during the same hospitalization.We report a detailed review of the literature focusing on technical details,risks and benefits of endoscopic management of SV in childhood.展开更多
文摘BACKGROUND Duodenal duplications are rare congenital anomalies of the gastrointestinal tract.As the periampullary variant is much rarer,literature is scant and only few authors have reported their experience in diagnosis and treatment,particularly with operative endoscopy.CASE SUMARY To report our experience with the endoscopic treatment in a series of children with periampullary duodenal duplication cysts,focusing on the importance of obtaining an accurate preoperative anatomic assessment of the malformations.The pediatric periampullary duodenal duplication cyst literature is reviewed.We conducted a systematic review according to the PRISMA guidelines.The PubMed database was searched for original studies on“duodenal duplication”,“periampullary duplication”or“endoscopic management”published since 1990,involving patients younger than 18 years of age.Eligible study designs were case report,case series and reviews.We analyzed the data and reported the results in table and text.Fifteen eligible articles met the inclusion criteria with 16 patients,and analysis was extended to our additional 4 cases.Median age at diagnosis was 13.5 years.Endoscopic treatment was performed in 10(50%)patients,with only 2 registered complications.CONCLUSION Periampullary duodenal duplication cysts in pediatric patients are very rare.Our experience suggests that an accurate preoperative assessment is critical.In the presence of sludge or stones inside the duplication,endoscopic retrograde cholangio-pancreatography is mandatory to demonstrate a communication with the biliary tree.Endoscopic treatment resulted in a safe,minimally invasive and effective treatment.In periampullary duodenal duplication cyst endoscopically treated children,long-term follow-up is still necessary considering the potential malignant transformation at the duplication site.
文摘Sigmoid volvulus(SV)is extremely uncommon in children and is usually associated with a long-standing history of constipation or pseudo-obstruction.An early diagnosis and management are crucial in order to prevent the appearance of hemorrhagic infarction of the twisted loop,avoiding further complications such as necrosis,perforation and sepsis.In patients with no evidence of peritonitis or ischemic bowel,treatment starts with resuscitation and detorsion of the SV,accomplished by means of sigmoidoscopy and concomitant rectal tube placement.The bowel is then prepared and surgery is undertaken electively during the same hospitalization.We report a detailed review of the literature focusing on technical details,risks and benefits of endoscopic management of SV in childhood.
