1.Clinical features,diagnosis,and treatment of gastric duplication in childhood
Wei WANG ; Jinbao HAN ; Shuanling LI ; Li WANG ; Yiyuan LIANG ; Qiulong SHEN ; Xianling LI ; Tingting LIU ; Dayong WANG ; Liuming HUANG
Journal of Clinical Surgery 2025;33(5):461-465
Objective To investigate the clinical characteristics,diagnosis,and treatment of gastric duplication(GD)in children.Methods A retrospective analysis was conducted on the clinical data of 46 pediatric patients with GD treated at our hospital from January 2008 to January 2025.The evaluated parameters included age,gender,symptoms,comorbidities,imaging data,surgical process,postoperative treatment and follow-up situation.Analyze the clinical characteristics of GD.Results Forty-four cases were cystic structures,and 2 cases were sinus tracts or tubular structures respectively.The most common site was the cardia/fundus area(20 cases).Seventeen cases were asymptomatic(7 detected during prenatal screening and 10 identified incidentally).The most common associated anomalies were inguinal hernia(4 cases),pulmonary airway malformation(3 cases),pulmonary sequestration(3 cases),and hiatal hernia(3 cases).All 46 patients underwent ultrasound examination,with an accuracy of 97.8%.Upper gastrointestinal contrast studies were performed in 16 cases and computed tomography(CT)was conducted in 34 patients.Perforation occurred in 7 cases.Surgical approaches included laparoscopy(35 cases,with 5 conversions to open surgery),open surgery(9 cases),robotic surgery(1 case),transthoracic surgery(1 case).Operative time ranged from 50 to 250 minutes(median:105 minutes).Postoperative pathology identified pancreatic heterotopia in 6 cases.Time to resume oral intake ranged from 1 to 17 days(median:4 days),and postoperative hospital stay lasted 3-21 days(median:7 days).During follow-up,one patient was readmitted for adhesive intestinal obstruction and managed conservatively,with no other significant complications reported.Conclusion Pediatric GD is a rare congenital anomaly,typically presenting as non-communicating cystic lesions with nonspecific clinical manifestations.Ultrasonography is the primary diagnostic tool,with upper GI series,CT/MRI,and endoscopy as adjuncts.While prompt surgical intervention is indicated for symptomatic cases,those complicated by perforation/infection should undergo delayed elective resection ≥ 3 months following complete inflammatory resolution.Laparoscopic approach is the treatment of choice,while endoscopic intraoperative localization or endoscopic therapy may be considered for small intraluminal lesions.
2.Clinical features,diagnosis,and treatment of gastric duplication in childhood
Wei WANG ; Jinbao HAN ; Shuanling LI ; Li WANG ; Yiyuan LIANG ; Qiulong SHEN ; Xianling LI ; Tingting LIU ; Dayong WANG ; Liuming HUANG
Journal of Clinical Surgery 2025;33(5):461-465
Objective To investigate the clinical characteristics,diagnosis,and treatment of gastric duplication(GD)in children.Methods A retrospective analysis was conducted on the clinical data of 46 pediatric patients with GD treated at our hospital from January 2008 to January 2025.The evaluated parameters included age,gender,symptoms,comorbidities,imaging data,surgical process,postoperative treatment and follow-up situation.Analyze the clinical characteristics of GD.Results Forty-four cases were cystic structures,and 2 cases were sinus tracts or tubular structures respectively.The most common site was the cardia/fundus area(20 cases).Seventeen cases were asymptomatic(7 detected during prenatal screening and 10 identified incidentally).The most common associated anomalies were inguinal hernia(4 cases),pulmonary airway malformation(3 cases),pulmonary sequestration(3 cases),and hiatal hernia(3 cases).All 46 patients underwent ultrasound examination,with an accuracy of 97.8%.Upper gastrointestinal contrast studies were performed in 16 cases and computed tomography(CT)was conducted in 34 patients.Perforation occurred in 7 cases.Surgical approaches included laparoscopy(35 cases,with 5 conversions to open surgery),open surgery(9 cases),robotic surgery(1 case),transthoracic surgery(1 case).Operative time ranged from 50 to 250 minutes(median:105 minutes).Postoperative pathology identified pancreatic heterotopia in 6 cases.Time to resume oral intake ranged from 1 to 17 days(median:4 days),and postoperative hospital stay lasted 3-21 days(median:7 days).During follow-up,one patient was readmitted for adhesive intestinal obstruction and managed conservatively,with no other significant complications reported.Conclusion Pediatric GD is a rare congenital anomaly,typically presenting as non-communicating cystic lesions with nonspecific clinical manifestations.Ultrasonography is the primary diagnostic tool,with upper GI series,CT/MRI,and endoscopy as adjuncts.While prompt surgical intervention is indicated for symptomatic cases,those complicated by perforation/infection should undergo delayed elective resection ≥ 3 months following complete inflammatory resolution.Laparoscopic approach is the treatment of choice,while endoscopic intraoperative localization or endoscopic therapy may be considered for small intraluminal lesions.
3.Clinical features, diagnosis and treatment of intussusception secondary to inverted Meckel′s diverticulum in children
Li WANG ; Dayong WANG ; Siwei WANG ; Tingting LIU ; Qiulong SHEN ; Xianling LI ; Shuanling LI
Chinese Journal of Applied Clinical Pediatrics 2022;37(19):1482-1485
Objective:To explore the clinical characteristics, diagnosis, treatment and prognosis of inverted Meckel′s diverticulum in children, and to summarize the clinical experience.Methods:Ten children who received surgical treatment in Beijing Children′s Hospital, Capital Medical University from October 2018 to October 2021 were retrospectively analyzed.The children were diagnosed with Mecker′s diverticulum.Their data were complete and their fo-llow-up information was available.The clinical features, diagnosis, treatment and prognosis were summarized.There were 6 males and 4 females, whose age of onset ranged from 5 months to 12 years and 5 months.The clinical manifestations were abdominal pain in 8 cases, crying in 2 cases and bloody stool in 3 cases.B-ultrasound showed suspected diseases secondary to inverted Meckel′s diverticulum, including small intestinal intussusception in 6 cases and back junction type intussusception in 4 cases.One case of small intestinal intussusception was misdiagnosed after laparoscopic exploration in other hospitals and suffered from recurrent intussusception.All patients underwent segmental bowel resection.Results:Of the 10 children, 8 cases received laparoscopic exploration and 2 cases underwent open surgery for secondary intestinal necrosis.Postoperative pathology revealed Meckel′s diverticulum.Ectopic tissue was accessible in 8 cases, including ectopic gastric tissue in 7 cases, and ectopic pancreas in 1 case.During the postoperative follow-up period (1 month-3 years), the patients were generally in good condition with no complications such as intestinal obstruction.Conclusions:Intussusception secondary to inverted Meckel′s diverticulum is rare and difficult to diagnose before operation.The diagnosis should be confirmed by surgical exploration and postoperative pathology.However, careful surgical exploration is required since inverted Meckel′s diverticulum is prone to be misdiagnosed during exploration.

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