Yan Jiayu,Guo Jianlin,Chen Wei,et al.Adenomyomatosis of gallbladder in childhood:a report of 3 cases with a literature review[J].Journal of Clinical Pediatric Surgery,,():1081-1086.[doi:10.3760/cma.j.cn101785-202207040-017]
Adenomyomatosis of gallbladder in childhood:a report of 3 cases with a literature review
- Keywords:
- Adenomyomatosis of Gallbladder; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the clinical features of adenomyomatosis of gallbladder (AMG) in children and improve pediatrician’s awareness. Methods Clinical data were retrospectively reviewed for 3 AMG cases from January 2007 to June 2022 at Beijing Children’s Hospital.Literature related to AMG children was retrieved from PubMed,Web of Science,Wanfang and China National Knowledge Infrastructure (CNKI) until June 2022 for analyzing the clinical types,diagnoses,treatments and outcomes. Results A total of 19 AMG children (10 boys,9 girls) have been reported.The mean admission age was 10 year (12 day-17 year).Fourteen cases (14/19,73.7%) had abdominal pain (14/14,100.0%).Abdominal tenderness (8/14,57.1%) was a major positive sign.Only 3 cases (3/14,21.4%) had abnormal laboratory results.Thirteen cases underwent laparotomy or laparoscopic cholecystectomy.Nine cases fared well during an average follow-up period of 12(3-60) month.One child received conservative observations due to a lack of apparent symptoms or positive signs.Among 5 cases without the relevant clinical symptoms,4 were conservatively observed.In 2 cases,AMG signs disappeared at Months 4 and 15.Ultrasonic improvement occurred at Month 8 in one case and there was no significant ultrasonic change at Month 3 in another.One child was operated without follow-ups.Abdominal ultrasonography (18/19,94.7%) and magnetic resonance imaging (MRI)(9/19,47.4%) were performed.In conjunctions with imaging examinations and postoperative pathological results,AMG classifications of 18 children were reported as diffuse (n=7),focal (n=5),segmental (n=5) and focal segmental (n=1). Conclusions AMG classification in children differs from that in adults.Clinical symptoms,physical examinations and laboratory results are generally non-specific in AMG patients.A definite diagnosis is dependent upon imaging examinations.For AMG children with obvious clinical symptoms and imaging signs,cholecystectomy should be performed with decent outcomes.
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Memo
收稿日期:2022-7-23。
通讯作者:陈巍,Email:chenwei710@hotmail.com;陈亚军,Email:chenyajunmd@aliyun.com