Zusammenfassung
Duplikaturen des Verdauungstraktes sind seltene Fehlbildungen, die zumeist schwierig zu diagnostizieren sind. Aufgrund unspezifischer Symptome können sie andere Erkrankungen imitieren und zu Fehldiagnosen wie einer Appendizitis führen. Es wird über einen 9-jährigen Jungen berichtet, bei dem aufgrund chronischer rezidivierender Unterbauchschmerzen eine laparoskopische Appendektomie durchgeführt wurde. Ursächlich für die Beschwerden war jedoch eine Dünndarmduplikatur mit ektoper Magenschleimhaut, die zu einem Ulkus und zu einer Invagination geführt hatte. Mit der hochauflösenden Sonographie war die Invagination nachweisbar.
Abstract
Duplications of the alimentary tract are rare congenital anomalies, which may be difficult to diagnose. They cause unspecific symptoms and may mimic appendicitis. The authors report the case of a 9-year-old boy with recurrent pain in the right lower abdomen who underwent laparoscopic appendectomy. The painful episodes were, however, caused by a duplication with ectopic gastric mucosa, which had lead to an ulceration and an intussusception. Sonographically using a high resolution linear probe (7.5 MHz) the ileal intussusception could be demonstrated.
Schlüsselwörter
Gastrointestinaltrakt - Duplikatur - Magenschleimhaut - Invagination - Appendektomie
Key words
Gastrointestinal tract - intestinal duplication - gastric mucosa - intussusception - appendectomy
Literatur
-
1
Iyer C P, Mahour H G.
Duplications of the alimentary tract in Infants and Children.
Journal of Pediatric Surgery.
1995;
30
1267-1270
-
2
Brown R L, Azizkhan R G.
Gastrointestinal Bleeding in Infants and Children: Meckel’s Diverticulum and Intestinal Duplication.
Seminars in Pediatric Surgery.
1999;
8
202-209
-
3
Hocking M, Young D G.
Duplication of the alimentary tract.
Br J Surg.
1981;
68
92-96
-
4
Stern L E, Warner B W.
Gastrointestinal duplications.
Semin Pediatr Surg.
2000;
9
135-140
-
5
Soares-Oliveira M, Castanon M, Carvalho J L. et al .
Intestinal duplications. A survey of 18 cases.
An Esp Pediatr.
2002;
56 (5)
430-433
-
6
Stringer M D, Spitz L, Abel R. et al .
Management of alimentary tract duplication in children.
Br J Surg.
1995;
82 (1)
74-78
-
7
Li L, Zhang J Z, Wang Y X.
Vascular classification for small intestinal duplications: experience with 80 cases.
J Pediatr Surg.
1998;
33 (8)
1243-1245
-
8
Pinter A, Schubert W, Szemledy F. et al .
Duplication of the alimentary canal in infants and children.
Orv Hetil.
1992;
133 (16)
967-971
-
9 Gross R E. Duplications of the alimentary tract. The surgery of Infancy and Childhood. Philadelphia, PA; Saunders 1953: 221-245
-
10
Schleef J, Schalamon J.
The role of laparoscopy in the diagnosis and treatment of intestinal duplication in childhood. A report of two cases.
Surg Endosc.
2000;
14 (9)
865
-
11
Rosati R, Giudiceandrea F, Filingeri V. et al .
Observations concerning an unusual presentation in a case of intestinal duplication.
Minerva Chir.
2000;
55
73-76
-
12
Dresler C M, Patterson G A, Taylor B R. et al .
Complete foregut duplication.
Ann Thorac Surg.
1990;
50 (2)
306-308
-
13
Frittelli P, Costa G, Zanella L. et al .
Intestinal duplication in the adult. A case report of colonic duplication and a review of the literature.
Chir Ital.
2002;
54 (5)
721-728
-
14
Hackkam D J, Zalev A, Burnstein M. et al .
Enteric duplication in the adult, derived from the foregut, midgut and hindgut: presentation, patterns and literature review.
Can J Surg.
1997;
40 (2)
129-133
-
15
Zamir G, Gross E, Shmushkevich A. et al .
Duodenal duplication cyst manifested by duodeno-jejunal intussusception and hyperbilirubinemia.
J Pediatr Surg.
1999;
34 (8)
1297-1299
-
16
Choi S O, Park W H, Kim S P.
Enteric duplications in children-an analysis of 6 cases.
Korean Med Sci.
1993;
8 (6)
482-487
-
17
Rizalar R, Somuncu S, Sozubir S. et al .
Cecal duplications: a rare cause for secondary intussusception.
Indian J Pediatr.
1996;
63 (4)
563-566
-
18
Guo J Z, Ma X Y, Zhou Q H.
Results of air pressure enema reduction of intussusception: 6,396 cases in 13 years.
J Pediatr Surg.
1986;
21
1201-1203
-
19
Kim Y S, Rhu J H.
Intussusception in infancy and childhood. Analysis of 385 cases.
Int Surg.
1989;
74 (2)
114-118
-
20
Kuruvilla T T, Naraynsingh V, Raju G C. et al .
Intussusception in infancy and childhood.
Trop Geogr Med.
1988;
40 (4)
342-346
-
21
Weisz B, Reif S, Spirer Z.
Intussusception in infants.
Harefuah.
1994;
126 (12)
704-707
-
22
Eklof O A, Johanson L, Lohr G.
Childhood intussusception: hydrostatic reducibility and incidence of leading points in different age groups.
Pediatr Radiol.
1980;
10 (2)
83-86
Dr. M. Born
Radiologische Klinik, Universität Bonn
Adenauerallee 119
53113 Bonn
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eMail: mark.born@ukb.uni-bonn.de
