Objective:To summarize the diagnosis and treatment of complications related to abdominal lymphangioma in children.Methods:The clinical data of 18 children with complications related to abdominal lymphangioma in Anhui Provincial Children′s Hospital from January 2016 to January 2020 were collected. The clinical manifestations, radiological characteristics, diagnosis, treatment and prognosis were retrospectively analyzed.Results:Among the 18 children, there were 4 cases with secondary infection, 3 cases with hemorrhage, 2 cases with rupture and 9 cases with intestinal obstruction. The ultrasonic diagnosis was accurately in 13 cases, and CT diagnosis was accurately in 16 cases. Conservative treatment was performed first for 2 cases with secondary infection and 1 case with rupture, and then radical operation was performed after the condition was stable. One case with macrosis lymphangioma of transverse colon complicated with infection underwent cyst external drainage in emergency first, and surgical resection of the tumor was carried out after 2 months. The other 14 cases were treated with one-stage radical operation, and the operation was successfully. There were 8 cases with single port laparoscopic assisted operation and 10 cases with open operation. Postoperative recovery was satisfactory and no complications such as chylous leakage occurred. The hospital stays after operation was (6.6 ± 1.8) d, among which the hospital stays after operation of single port laparoscopic assisted operation was (5.4 ± 1.4) d, and open operation was (7.6 ± 1.6) d. All children were followed up for 3 months to 2 years, and no single case recurred.Conclusions:Complications of abdominal lymphangioma in children are rare. Abdominal ultrasound and CT can be used as routine examination to evaluate the condition of the disease. The operation is a safe and effective procedure in clinical practice. The individualized treatment measures should be chosen according to the clinical condition.

Objective To evaluate the diagnostic value of magnetic resonance enterography(MRE)and ectopic gastric mucosa imaging(EGMI)in children with lower gastrointestinal hemorrhage.Methods The clinical data including gender,age,amount of bleeding and preoperative minimum hemoglobin(Hb)levels of 54 children with lower gastrointestinal hemorrhage were collected,who received surgical exploration in Department of Pediatric Surgery,Anhui Provincial Children's Hospital between February 2014 and April 2016.Children were divided into lesion group and non-lesion group according to the findings of surgical exploration.Lesion group were defined as children with Meckel's diverticulum(MD)or duplication of the small intestine by surgery and postoperative pathological findings.A total of 36 cases,25 cases of boys,11 cases of girls,aged(2.86±1.59)years old.Non-lesion group were defined as children,who underwent operation with negative result or with lesions but not MD or duplication of the small intestine.A total of 18 cases,14 cases of boys,4 cases of girls,aged(3.87±1.62)years old.MRE and EGMI were performed when the children stopped bleeding,before the inspection,should fasting for 4-6 h.SPSS 13.0 software was used for statistical processing.The evaluation of EGMI,MRE and the both in diagnosing MD or duplication of the small intestine were conducted by receiver operating characteristic curve(ROC).According to the principles of biggest gain best diagnostic value by Youden index,and the degree of sensitivity and specificity was calculated at this time,P<0.05 for the difference was statistically significant.Results There was no significant differences statistically in gender between 2 groups(x2=0.415,P>0.05).There were statistically significant differences in age,amount of bleeding and preoperative minimum hemoglobin levels(t=2.179,2.027,2.222,all P<0.05).There were statistically significant differences in classification comparison by EGMI and MRE between 2 groups(x2=15.226,29.121,all P<0.01).The optimal cut-off value of EGMI and MRE in the diagnosis of enteric malformation was more than level 3,and the suspected positive and being positive value was assigned as positive results.According to the cut-off value above,EGMI,MRE and EGMI plus MRE in series and in parallel in the diagnosis of enteric malformation,the areas under curves(AUC)were 0.809,0.917,0.750 and 0.847,respectively.The sensitivity was 61.1％,75.0％,55.6％and 80.6％,respectively.The specificity was 90.4％,94.4％,94.4％and 88.9％,respectively.The Youden's indexes were 0.515,0.694,0.500 and 0.695,respectively.The optimal cut-off value of age and preoperative minimum hemoglobin levels in the diagnosis of enteric malformation were 2.92 years and 80 g/L,respectively.The AUC was 0.761 and 0.672.The Youden's indexes were 0.515 and 0.333.There was no significant differences statistically in AUC compared with age,MRE and EGMI(all P<0.05).Conclusions The high diagnostic value in children with lower gastrointestinal hemorrhage is found by using MRE and EGMI.Then,MRE as a separate diagnosis method is also worthy of clinical application.

Objective:To explore the clinical characteristic, pathogenesis, diagnosis and treatment strategies of gastroinstinal injury caused by magnets ingestion in children.Methods:A retrospective analysis of 46 patients with gastrointestinal tract magnets ingestion in Anhui Provincial Children′s Hospital from October 2017 to September 2021 was performed. Patients were divided into different groups according to gastroinstinal perforation. Some basic information was collected, including gender, age, duration of swallow foreign bodies, quantity of foreign bodies, symptoms, white blood cell, neutrophil, C-reactive protein, therapeutic method, gastroinstinal injury and follow up. Logistic regression. Univariate analysis and multivariate Logistic regression were used to analysis the risk factors of gastroinstinal perforation. Continuous parametric data were summarized using median and interquartile range, differences were evaluated using Wilcoxon Mann-Whitney test.Noncontinuous data were analyzed using chi-square test or corrected chi-square test.Results:Among the 46 patients, there were 33 males and 13 females. The median age was 3 years, with a range of 8 months to 11years. 34 cases had a history of ingesting magnets. The common number of ingested magnets was 2-10 (25 cases). Vomiting (18 cases) and abdominal pain (13 cases)were the commonest complaint. 6 cases tend to pass through the gastrointestinal tract uneventfully, and the remaining cases were successfully extracted by endoscopy (5 cases) and surgery(35 cases). Gastroinstinal perforation was found in 28 cases, and the majority of perforation was located in the ileum (18 cases). Univariate analysis showed that symptom, white blood cell, neutrophil, and CRP were associated with gastroinstinal perforation ( P<0.05). Multivariate Logistic regression analysis showed that symptom( OR=4.715, 95% CI: 1.074-20.696, P=0.040) and CRP( OR=11.605, 95% CI: 1.132-118.981, P=0.039) were independent factors for gastroinstinal perforation. There was no significant correlation between the number of magnets and gastroinstinal perforation ( r=0.276, P>0.05). Conclusions:The ingestion of magnetic foreign bodies in children often requires urgent management.When magnets are located within the prepyloric part of the GI tract, retrieval by endoscopy is recommended.The surgical intervention is required as soon as possible due to the failure of endoscopic treatment.

Objective:To evaluate the risk factors for prognosis of primary intussusception treated by enema reduction in children.Methods:A retrospective analysis of 519 patients with primary intussusception in Anhui Provincial Children′s Hospital from January 2017 to December 2020 was performed. Among the 519 patients, there were 346 males and 173 females. The median age was 15 months, with a range of 3 to 69 months, some basic information was collected. Patients were divided into bad prognosis group ( n=71) and good prognosis group ( n=448) according to prognosis.Propensity score matching (PSM) was conducted to reduce confounding bias between the groups. Conditional logistic regression were used to analysis the risk factors of primary intussusception treated by enema reduction. Results:There were 71 cases of poor prognosis among 519 primary intussusception patients, incidence was 13.7%.Before PSM, there was significant difference in 6 covariates, including gender, age, duration of symptoms, bloody stool, diarrhoea and fever between two group ( P<0.05). There was no significant difference in abdominal pain and vomit between two group ( P>0.05). With propensity score matching, 69 pairs of patients were sucessfully matched. After PSM, distribution of the above covariates reached equilibrium between two groups ( P>0.05). There were statistically significant differences in enema reduction, mass location, seroperitoneum, lactic acid and overweight/obese between the two groups ( P<0.05). Conditional logistic regression analysis confirmed that enema reduction( OR=3.478, 95% CI: 1.150-10.517, P=0.027), mass location ( OR=6.596, 95% CI: 1.669-26.056, P=0.007), lactic acid( OR=1.012, 95% CI: 1.003-1.021, P=0.010), overweight/obese ( OR=6.085, 95% CI: 1.650-22.436, P=0.007) were independent factors for predicting prognosis of primary intussusception treated by enema reduction. Conclusions:AER, mass located left hemicolon, elevated lactic acid and overweight/obese were independent risk factors for poor prognosis of primary intussusception treated by enema reduction.