Adenomyomatosis of the gallbladder in childhood: A systematic review of the literature and an additional case report  

作　　者：Filippo Parolini Giuseppe Indolfi Miguel Garcia Magne Marianna Salemme Maurizio Cheli Giovanni Boroni Daniele Alberti 

机构地区：[1]Department of Paediatric Surgery, "Spedali Civili" Children's Hospital [2]Department of Paediatrics, "Meyer" Children’s University Hospital [3]Department of Pathology, "Spedali Civili" Hospital [4]Department of Paediatric Surgery, "Papa Giovanni XXⅢ" Hospital [5]Clinical and Experimental Sciences, University of Brescia

出　　处：《World Journal of Clinical Pediatrics》2016年第2期223-227,共5页世界临床儿科杂志

摘　　要：AIM: To investigate the diagnostic and therapeutic assessment in children with adenomyomatosis of the gallbladder(AMG).METHODS: AMG is a degenerative disease characterized by a proliferation of the mucosal epithelium which deeply invaginates and extends into the thickened muscular layer of the gallbladder, causing intramural diverticula. Although AMG is found in up to 5% of cholecystectomy specimens in adult populations, this condition in childhood is extremely uncommon. Authors provide a detailed systematic review of the pediatric literature according to PRISMA guidelines, focusing on diagnostic and therapeutic assessment. An additional case of AMG is also presented. RESULTS:Five studies were finally enclosed, encompassing 5 children with AMG. Analysis was extended to our additional 11-year-old patient, who presented diffuse AMG and pancreatic acinar metaplasia of the gallbladder mucosa and was successfully managed with laparoscopic cholecystectomy. Mean age at presentation was 7.2 years. Unspecific abdominal pain was the commonest symptom. Abdominal ultrasound was performed on all patients, with a diagnostic accuracy of 100%. Five patients underwent cholecystectomy, and at follow-up were asymptomatic. In the remaining patient, completely asymptomatic at diagnosis, a conservative approach with monthly monitoring via ultrasonography was undertaken. CONCLUSION: Considering the remote but possible degeneration leading to cancer and the feasibility of laparoscopic cholecystectomy even in small children, evidence suggests that elective laparoscopic cholecystectomy represent the treatment of choice. Preoperative evaluation of the extrahepatic biliary tree anatomy with cholangio-MRI is strongly recommended.AIM: To investigate the diagnostic and therapeutic assessment in children with adenomyomatosis of the gallbladder(AMG).METHODS: AMG is a degenerative disease characterized by a proliferation of the mucosal epithelium which deeply invaginates and extends into the thickened muscular layer of the gallbladder, causing intramural diverticula. Although AMG is found in up to 5% of cholecystectomy specimens in adult populations, this condition in childhood is extremely uncommon. Authors provide a detailed systematic review of the pediatric literature according to PRISMA guidelines, focusing on diagnostic and therapeutic assessment. An additional case of AMG is also presented. RESULTS:Five studies were finally enclosed, encompassing 5 children with AMG. Analysis was extended to our additional 11-year-old patient, who presented diffuse AMG and pancreatic acinar metaplasia of the gallbladder mucosa and was successfully managed with laparoscopic cholecystectomy. Mean age at presentation was 7.2 years. Unspecific abdominal pain was the commonest symptom. Abdominal ultrasound was performed on all patients, with a diagnostic accuracy of 100%. Five patients underwent cholecystectomy, and at follow-up were asymptomatic. In the remaining patient, completely asymptomatic at diagnosis, a conservative approach with monthly monitoring via ultrasonography was undertaken. CONCLUSION: Considering the remote but possible degeneration leading to cancer and the feasibility of laparoscopic cholecystectomy even in small children, evidence suggests that elective laparoscopic cholecystectomy represent the treatment of choice. Preoperative evaluation of the extrahepatic biliary tree anatomy with cholangio-MRI is strongly recommended.

关 键 词：ADENOMYOMATOSIS CHILDREN GALLBLADDER LAPAROSCOPY ULTRASOUND 

分 类 号：R726.5[医药卫生—儿科]