单通道腹腔镜治疗异位胰腺致11 个月婴儿继发性肠套叠

doi:10.3877/cma.j.issn.1674-6899.2024.06.009

中华腔镜外科杂志(电子版) ›› 2024, Vol. 17 ›› Issue (06) : 365 -367. doi: 10.3877/cma.j.issn.1674-6899.2024.06.009

临床技术

单通道腹腔镜治疗异位胰腺致11 个月婴儿继发性肠套叠

古浩¹^,², 荆玉雷¹^,^†(

), 王达丰¹, 金鑫¹, 蔡义进¹, 禚孝颖¹, 石英佐¹

1.530031 无锡，江南大学附属儿童医院小儿外科
2.211103 南京医科大学无锡医学中心

收稿日期:2024-06-24 出版日期:2024-12-30
通信作者: 荆玉雷

Single-site laparoscopic treatment of pathological intussusception secondary to heterotopic pancreas in an 11-month old infant： a case report

Hao Gu¹^,², Yulei Jing¹^,^†(), Dafeng Wang¹, Xin Jin¹, Yijin Cai¹, Xiaoying Zhuo¹, Yingzuo Shi¹

1.Department of Pediatric Surgery，The Affiliated Children′s Hospital of Jiangnan University，Wuxi 214023，China
2.Wuxi Medical Center，Nanjing Medical University，211103，China

Received:2024-06-24 Published:2024-12-30
Corresponding author: Yulei Jing

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目的

探讨腹腔镜在空气灌肠失败的肠套叠治疗中的应用，提高临床医师对继发性肠套叠的认识。

方法

患儿短期内反复发生肠套叠且空气灌肠不能整复，结合相关文献，与患者家属充分沟通后，行单通道腹腔镜辅助下肠套叠整复治疗。

结果

患儿术后恢复顺利，术后病理证实为回肠异位胰腺，腺体内见腺泡及润管结构。术后第4 天恢复流质饮食，无呕吐、腹胀等不良反应，无吻合口漏及狭窄等并发症，术后第6 天出院。

结论

腹腔镜治疗肠套叠具有创伤小、术后恢复快的优势，并能取得不错的美容效果，相比传统开腹手术具有一定的优势。

关键词: 单通道腹腔镜, 异位胰腺, 继发性肠套叠

Objective

To explore the application of laparoscopy in the treatment of intussusception failed by air enema，and to improve clinicians'understanding of secondary intussusception.

Methods

In the short-term recurrence of intussusception and air enema failure，combined with relevant literature，after full communication with the patient′s family，single-channel laparoscopic assisted intussusception reconstruction treatment was performed.

Results

Postoperative recovery was smooth，and postoperative pathology confirmed that the patient had an ectopic pancreas in the ileum，with alveolar and ductal structures seen in the gland. The child resumed liquid diet on the 4th postoperative day，with no adverse reactions such as vomiting and abdominal distension，no complications such as anastomotic leakage and stenosis，and was discharged from the hospital on the 6th postoperative day.

Conclusions

Laparoscopic treatment of intussusception has the advantages of less trauma，faster postoperative recovery，and good cosmetic results，compared with traditional open surgery.

Key words: Heterotopic pancreas, Pathological intussusception, Single-site laparoscopic

图1 患儿入院到出院的重要影像、病理资料及图像注：A. 腹部超声检查诊断为右下腹肠套叠；B. 入院前空气灌肠成功复位；C.入院后两次空气灌肠失败；D.肠系膜对侧缘的肠浆膜下发现的一个直径为1 cm 的异常肿块，肠套叠的病理可能导联点；E、F.病理检查证实回肠浆膜内有分离的异位胰腺组织；G.患儿出院时恢复情况

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