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中华妇幼临床医学杂志(电子版) ›› 2008, Vol. 04 ›› Issue (03) : 208 -211. doi: 10.3877/cma.j.issn.1673-5250.2008.03.110

论著

巨大网膜囊肿误诊分析
徐畅, 刘文英, 王元祥, 向波, 陈中献   
  1. 四川大学华西医院小儿外科(成都,610041)
  • 出版日期:2008-06-01

To Analyze the Misdiagnosis of Huge Omental Cyst

Chang XU, Wen-ying LIU, Yuan-xiang WANG, Bo XIANG, Zhong-xian CHEN   

  1. Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
  • Published:2008-06-01
引用本文:

徐畅, 刘文英, 王元祥, 向波, 陈中献. 巨大网膜囊肿误诊分析[J]. 中华妇幼临床医学杂志(电子版), 2008, 04(03): 208-211.

Chang XU, Wen-ying LIU, Yuan-xiang WANG, Bo XIANG, Zhong-xian CHEN. To Analyze the Misdiagnosis of Huge Omental Cyst[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2008, 04(03): 208-211.

目的

探讨巨大网膜囊肿的误诊原因和诊断要点。

方法

本研究采用回顾性分析法分析本院近4年(2003年至2006年)诊治的3例巨大网膜囊肿误诊病例。

结果

本研究3例患儿最后均确诊为淋巴管瘤型网膜囊肿,由于瘤体巨大,几乎占据整个腹腔,其表现无论是体格检查,还是超声及CT检查结果,均与腹水症状相似,极易发生误诊。3例患儿中,误诊时间最长者达4年之久。

结论

以腹水为主要临床表现的疾病,并不一定都是腹水症。若患儿无明确导致腹水的病因,特别在内科按常规腹水治疗无效时,应结合相关检查结果进行综合分析,并考虑巨大网膜囊肿的可能。

Objective

To discuss the cause of misdiagnosis of huge omental cyst and key diagnosis points.

Methods

3 cases of omental cyst which were misdiagnosed in the past 4 years were studied retrospectively (from 2003 to 2006).

Results

All of the 3 children had huge omental cysts which were the lymphangioma. Due to the size and tendency to occupy every available space in the abdomen, clinical manifestations, not only in the features of medical examination but also in the results of ultrasound and CT, were similar with ascites, which easily leaded to a misdiagnosis. The longest time of misdiagnosis was up to 4 years among those 3 children.

Conclusion

Children with grossly distended, fluid filled abdomen need not have ascites. If the cause of ascites is not available, especially when the medical therapy is inefficient, aggregate analysis should be available, associated with all aspects of examination results, and the possibility of huge omental cyst should be taken into account.

图1 由于囊肿的挤压作用,使肠袢比较集中,聚集并紧贴腹后壁,肠袢间无明显的液性区域
图2 打开腹膜后即见到与之紧贴的薄壁囊性包块,包块上至肝下,下至盆底直肠膀胱陷窝,前后紧贴腹前后壁,几乎占满了整个腹腔。囊肿呈单发多房性,内有较多薄膜状分隔
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