临床外科杂志 ›› 2025, Vol. 33 ›› Issue (5): 461-465.doi: 10.3969/j.issn.1005-6483.20250398

• 论著 • 上一篇    下一篇

儿童期胃重复畸形的临床特点及诊治

  

  1. 100045  国家儿童医学中心 首都医科大学附属北京儿童医院急诊外科
  • 收稿日期:2025-04-15 接受日期:2025-04-15 出版日期:2025-05-20 发布日期:2025-05-20
  • 通讯作者: 黄柳明,Email:surhlm@163.com
  • 基金资助:
    军委后勤保障部卫生局科技项目(No21JSZ18)

Clinical features,diagnosis,and treatment of gastric duplication in childhood

  1. Department of Emergency Surgery,Beijing Children’s Hospital,Capilal Medical University,National Center for Children’s Health,Beijing 100045,China
  • Received:2025-04-15 Accepted:2025-04-15 Online:2025-05-20 Published:2025-05-20

摘要: 目的 探讨儿童胃重复畸形(GD)的临床特征及诊治方法。方法  回顾性分析2008年1月~2025年1月收治的46例GD患儿的临床资料,包括年龄、性别、症状、合并症、影像学资料、手术经过、术后治疗及随访情况。分析GD的临床特征。结果 44例为囊性结构,2例分别为窦道或管状结构。最常见的部位为贲门/胃底区(20例)。无症状者17例(产检7例,检查无意发现者10例)。最常见的合并症为腹股沟斜疝(4例)、肺气道畸形(3例)、隔离肺(3例)、食管裂孔疝(3例)。46例患儿均行超声检查,准确率97.8%。16例病人行上消化道造影。34例病人行CT检查。术前发生穿孔7例。手术方式包括腹腔镜35例(中转开腹5例),开腹手术9例,机器人手术1例,经胸手术1例。手术时间50~250分钟(中位数105分钟)。术后病理检查提示合并胰腺异位6例。术后开始进食时间为1~17天(中位数4天),术后住院时间为3~21天(中位数7天)。术后随访1例因粘连性肠梗阻再次入院保守治疗,余无明显并发症。结论 儿童GD较为罕见,多为孤立囊肿、与胃腔不通,临床表现无特异性。超声检查可作为首选检查方法,上消化道造影、CT/MRI、胃镜多种辅助检查联合有助于诊断。有症状者应尽早手术,但穿孔感染者,应在炎症消退后、间隔不低于3个月后择期手术。腹腔镜手术为首选方式,病灶较小的腔内型GD可胃镜辅助术中定位或内镜下治疗。

关键词: 胃重复畸形, 儿童, 诊断, 治疗

Abstract: Methods A retrospective analysis was conducted on the clinical data of 46 pediatric patients with GD treated at our hospital from January 2008 to January 2025.The evaluated parameters included age,gender,symptoms,comorbidities,imaging data,surgical process,postoperative treatment and follow-up situation.Analyze the clinical characteristics of GD.
Results Forty-four cases were cystic structures,and 2 cases were sinus tracts or tubular structures respectively.The most common site was the cardia/fundus area (20 cases).Seventeen cases were asymptomatic(7 detected during prenatal screening and 10 identified incidentally).The most common associated anomalies were inguinal hernia(4 cases),pulmonary airway malformation(3 cases),pulmonary sequestration(3 cases),and hiatal hernia(3 cases).All 46 patients underwent ultrasound examination,with an accuracy of 97.8%.Upper gastrointestinal contrast studies were performed in 16 cases and computed tomography(CT) was conducted in 34 patients.Perforation occurred in 7 cases.Surgical approaches included laparoscopy(35 cases,with 5 conversions to open surgery),open surgery(9 cases),robotic surgery(1 case),transthoracic surgery(1 case).Operative time ranged from 50 to 250 minutes(median:105 minutes).Postoperative pathology identified pancreatic heterotopia in 6 cases.Time to resume oral intake ranged from 1 to 17 days(median:4 days),and postoperative hospital stay lasted 3~21 days(median:7 days).During follow-up,one patient was readmitted for adhesive intestinal obstruction and managed conservatively,with no other significant complications reported.Conclusion Pediatric GD is a rare congenital anomaly,typically presenting as non-communicating cystic lesions with nonspecific clinical manifestations.Ultrasonography is the primary diagnostic tool,with upper GI series,CT/MRI,and endoscopy as adjuncts.While prompt surgical intervention is indicated for symptomatic cases,those complicated by perforation/infection should undergo delayed elective resection ≥3 months following complete inflammatory resolution.Laparoscopic approach is the treatment of choice,while endoscopic intraoperative localization or endoscopic therapy may be considered for small intraluminal lesions.

Key words: gastric duplication, children, diagnosis, treatment

[1] 李文海 卞红强. 儿童轻微胆总管扩张诊治策略[J]. 临床外科杂志, 2025, 33(5): 449-452.
[2] 柳博文 李天宇. 输尿管软镜碎石术在儿童上尿路结石中的应用[J]. 临床外科杂志, 2025, 33(5): 453-456.
[3] 倪曲波, 吕佳豪, 陈廖斌. 腓骨肌腱滑脱症的诊治现状[J]. 临床外科杂志, 2025, 33(4): 353-356.
[4] 段建峰, 刘晓晨, 赵喜荣, 段昌虎, 杨帆, 陈青娟, 吴林, 赵李飞, 何桥. 52例中晚期肝癌“三联”转化治疗疗效的回顾性分析[J]. 临床外科杂志, 2025, 33(4): 420-423.
[5] 张晓莹, 房爱菊, 杨香山, 李静. 大汗腺分化的乳腺包裹性乳头状癌一例[J]. 临床外科杂志, 2025, 33(4): 447-448.
[6] 徐波 冯键华 蔡文松. 原发性甲状旁腺功能亢进症手术治疗的相关决策与处理[J]. 临床外科杂志, 2025, 33(3): 245-247.
[7] 匡镜潮 杨康 张辉 高绪照. 胆总管结石合并胆囊结石病人一期行内镜逆行胰胆管造影联合腹腔镜胆囊切除手术疗效分析[J]. 临床外科杂志, 2025, 33(3): 299-302.
[8] 胡迪 沈浩元. 长链非编码RNA HOTAIR在乳腺癌早期诊断中的价值和作用机制[J]. 临床外科杂志, 2025, 33(3): 329-331.
[9] 王豪 梁宾勇 梅斌. 以免疫检查点抑制剂为基础的肝细胞癌新辅助治疗进展[J]. 临床外科杂志, 2025, 33(3): 332-335.
[10] 侯俊 任俊丽 梁婷婷 刘晶怡 王开元 潘澄澄 马秀芬. 乳腺恶性叶状肿瘤伴皮肤破溃血性溢液一例[J]. 临床外科杂志, 2025, 33(3): 293-294.
[11] 庄义骏 许南炜 赵劲歌 曾浩. 2024年欧洲泌尿外科学会前列腺癌指南更新荟萃与解读[J]. 临床外科杂志, 2025, 33(2): 113-117.
[12] 王雪静 黄智 曾嘉宾 周楚芸 郑博文 吕世栋 魏强. 新一代人工智能在前列腺癌临床诊断的研究进展[J]. 临床外科杂志, 2025, 33(2): 118-122.
[13] 王柯若 于健鹏 牛远杰. 前列腺癌疫苗:临床研究进展与未来展望[J]. 临床外科杂志, 2025, 33(2): 129-133.
[14] 李先缪 依日夏提江·阿米尔 吴焕磊 胡嘏. 前列腺癌临床药物研究现状与发展[J]. 临床外科杂志, 2025, 33(2): 204-207.
[15] 袁浩 滕靖琰 张强. 免疫治疗在食管癌新辅助治疗中的研究进展[J]. 临床外科杂志, 2025, 33(2): 210-212.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 黄洪锋. 关注公民逝世后器官捐献肾移植受体围手术期感染的预防与处理[J]. 临床外科杂志, 2016, 24(10): 732 .
[2] 杨华;李新长;龙成美;等. 公民逝世后器官捐献供肾移植临床分析[J]. 临床外科杂志, 2016, 24(10): 747 .
[3] 宋华;单若冰;张晋绥;等. 产前超声诊断对新生儿消化道梗阻性疾病手术治疗价值的观察[J]. 临床外科杂志, 2016, 24(10): 780 .
[4] 刘琼;江辉. 喉罩在小儿舌系带矫正手术中的应用[J]. 临床外科杂志, 2016, 24(10): 792 .
[5] 李义亮;张成;克力木;等. 完全腹腔镜下远端胃癌根治术的临床体会[J]. 临床外科杂志, 2016, 24(10): 769 .
[6] 李光焰;张安平;王祥峰;等. 直肠癌切除术后吻合口狭窄14例分析[J]. 临床外科杂志, 2016, 24(10): 772 .
[7] 张忠伟;刘扬;路明. 痔上黏膜环切术治疗直肠前突所致出口梗阻型便秘的疗效观察[J]. 临床外科杂志, 2016, 24(10): 774 .
[8] 周观金;彭昊;陈森. 全膝关节置换治疗膝关节炎术后早期镇痛的研究进展[J]. 临床外科杂志, 2016, 24(10): 804 .
[9] 石宇;刘学刚 . 冠状动脉旁路移植术后短期内应用强化他汀对患者出血风险的研究[J]. 临床外科杂志, 2016, 24(10): 750 .
[10] 江帆;孙权;吴国俊;等. 不同引流方式对恶性梗阻性黄疸患者细胞免疫的影响[J]. 临床外科杂志, 2016, 24(10): 760 .