Surgical perspectives of symptomatic omphalomesenteric duct remnants: Differences between infancy and beyond  

作　　者：Ayoung Kang Soo-Hong Kim Yong-Hoon Cho Hae-Young Kim 

机构地区：[1]Department of Surgery,Pusan National University Yangsan Hospital,Yangsan 50612,South Korea [2]Department of Surgery,Pusan National University School of Medicine,Yangsan 50612,South Korea [3]Research Institute for Convergence of Biomedical Science and Technology,Pusan National University Yangsan Hospital,Yangsan 50612,South Korea

出　　处：《World Journal of Clinical Cases》2021年第36期11228-11236,共9页世界临床病例杂志

摘　　要：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 les

关 键 词：Omphalomesenteric duct remnant Age SURGICAL Meckel's diverticulum Single-incision laparoscopic surgery Children 

分 类 号：R726.5[医药卫生—儿科]