BACKGROUND The clinical manifestations of omphalomesenteric duct remnant(OMDR)can vary with the age at diagnosis,from asymptomatic incidental findings to symptoms related to gastrointestinal complications.The lifelong...BACKGROUND The clinical manifestations of omphalomesenteric duct remnant(OMDR)can vary with the age at diagnosis,from asymptomatic incidental findings to symptoms related to gastrointestinal complications.The lifelong complication rates are reported as 4%-34%,and complications are more common in patients younger than 2 years of age.The authors attempted to identify different clinical features and management for the various pediatric age groups.AIM To find surgical perspectives for the pediatric age-related variants of OMDR and make recommendations for optimal management.METHODS The medical records of pediatric patients diagnosed with OMDR were reviewed retrospectively.Fifteen patients diagnosed based on incidental findings during other surgeries were excluded.The patients were divided into two groups based on age:<12 mo(infants)and>12 mo(beyond infancy).We analyzed the demographic characteristics,clinical manifestations,diagnostic tools,surgical procedures,and clinical outcomes of the patients and compared them for the age groups.Chi-squared and Fisher's exact tests were used for nominal scales and a Mann-Whitney test was used for ratio scales.RESULTS A total of 35 patients(7 infants,28 children beyond infancy)were finally included.In both groups,Meckel's diverticulum(MD)was the most common type of OMDR,while umbilical lesions were more common in the infant group(P=0.006).Hematochezia and abdominal pain were common in the beyond infancy group,while umbilical lesions were the most frequent symptoms in the infant group.Several diagnostic tools were used,but Meckel's scan was most useful in diagnosing OMDR in patients with painless rectal bleeding.Minimally invasive surgery was more commonly performed for children than for infants(P=0.016).Single-incision laparoscopic surgery(SILS)was performed for fifteen patients who underwent laparoscopic surgery.There were only three cases of postoperative complications,and all patients survived in good condition.CONCLUSION The clinical type of OMDR varies with age,umbilical lesions in infants,and MD beyond infancy.SILS is effective for managing children with MD regardless of age.展开更多
58 children with gastrointestinal bleeding were examined for ectopic gastric mucosa with 99m Tc-pertechnetate. 25 cases who had abnormal uptake in 1 hour were diagnosed positive and among them 17 cases were operated o...58 children with gastrointestinal bleeding were examined for ectopic gastric mucosa with 99m Tc-pertechnetate. 25 cases who had abnormal uptake in 1 hour were diagnosed positive and among them 17 cases were operated on and final pathology diagnoses were made- The results showed that 5cases were Meckel's diverticulum, 8 alimentary duplication aberrations and 4 false positive inclusive of 1 enteric hemangioma and 1 enteric telangiectasia. From the results, duplications were more than Meckel's diverticulum which contained gastric mucosa. False positive can be avoided by using the early uptake phase and twice image in the first hour as diagnostic standard except enteric hemangioma and enteric teiangiectasia.展开更多
We herein report the case of a patient with rectal adenocarcinoma who underwent low anterior resection in our hospital. The patient experienced general peritonitis, septic shock, and ardent fever on postoperative day ...We herein report the case of a patient with rectal adenocarcinoma who underwent low anterior resection in our hospital. The patient experienced general peritonitis, septic shock, and ardent fever on postoperative day 3. An exploratory operation revealed a perforated proximal jejunal diverticulum.The patient then underwent total parenteral nutrition and succus entericus reinfusion. The metabolic disturbances and cacotrophy rapidly improved after reinfusion of intestinal secretions, and the patient was successfully cured without requiring a prolonged period of parenteral nutrition. Our data support the saying “If the gut is working, use it.” Our report also confirms the value of succus entericus reinfusion in the successful treatment of a spontaneous perforation of Meckel’s diverticulum after low anterior resection of the rectum.展开更多
文摘BACKGROUND The clinical manifestations of omphalomesenteric duct remnant(OMDR)can vary with the age at diagnosis,from asymptomatic incidental findings to symptoms related to gastrointestinal complications.The lifelong complication rates are reported as 4%-34%,and complications are more common in patients younger than 2 years of age.The authors attempted to identify different clinical features and management for the various pediatric age groups.AIM To find surgical perspectives for the pediatric age-related variants of OMDR and make recommendations for optimal management.METHODS The medical records of pediatric patients diagnosed with OMDR were reviewed retrospectively.Fifteen patients diagnosed based on incidental findings during other surgeries were excluded.The patients were divided into two groups based on age:<12 mo(infants)and>12 mo(beyond infancy).We analyzed the demographic characteristics,clinical manifestations,diagnostic tools,surgical procedures,and clinical outcomes of the patients and compared them for the age groups.Chi-squared and Fisher's exact tests were used for nominal scales and a Mann-Whitney test was used for ratio scales.RESULTS A total of 35 patients(7 infants,28 children beyond infancy)were finally included.In both groups,Meckel's diverticulum(MD)was the most common type of OMDR,while umbilical lesions were more common in the infant group(P=0.006).Hematochezia and abdominal pain were common in the beyond infancy group,while umbilical lesions were the most frequent symptoms in the infant group.Several diagnostic tools were used,but Meckel's scan was most useful in diagnosing OMDR in patients with painless rectal bleeding.Minimally invasive surgery was more commonly performed for children than for infants(P=0.016).Single-incision laparoscopic surgery(SILS)was performed for fifteen patients who underwent laparoscopic surgery.There were only three cases of postoperative complications,and all patients survived in good condition.CONCLUSION The clinical type of OMDR varies with age,umbilical lesions in infants,and MD beyond infancy.SILS is effective for managing children with MD regardless of age.
文摘58 children with gastrointestinal bleeding were examined for ectopic gastric mucosa with 99m Tc-pertechnetate. 25 cases who had abnormal uptake in 1 hour were diagnosed positive and among them 17 cases were operated on and final pathology diagnoses were made- The results showed that 5cases were Meckel's diverticulum, 8 alimentary duplication aberrations and 4 false positive inclusive of 1 enteric hemangioma and 1 enteric telangiectasia. From the results, duplications were more than Meckel's diverticulum which contained gastric mucosa. False positive can be avoided by using the early uptake phase and twice image in the first hour as diagnostic standard except enteric hemangioma and enteric teiangiectasia.
基金The National Natural Science Foundation of China (No.81472699).
文摘We herein report the case of a patient with rectal adenocarcinoma who underwent low anterior resection in our hospital. The patient experienced general peritonitis, septic shock, and ardent fever on postoperative day 3. An exploratory operation revealed a perforated proximal jejunal diverticulum.The patient then underwent total parenteral nutrition and succus entericus reinfusion. The metabolic disturbances and cacotrophy rapidly improved after reinfusion of intestinal secretions, and the patient was successfully cured without requiring a prolonged period of parenteral nutrition. Our data support the saying “If the gut is working, use it.” Our report also confirms the value of succus entericus reinfusion in the successful treatment of a spontaneous perforation of Meckel’s diverticulum after low anterior resection of the rectum.
