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儿童回盲部Burkitt淋巴瘤并发肠套叠1例并文献复习
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Abstract:
Burkitt淋巴瘤是发生于儿童时期的罕见恶性肿瘤,原发于消化道的Burkitt淋巴瘤起病隐匿,难以及时发现。有些患儿会因肠道肿瘤导致继发性肠套叠,出现相应的临床症状而就诊。本文报道1例回盲部Burkitt淋巴瘤并发肠套叠的病例,患儿因间断腹痛1周入院,行B超检查提示回肠末端淋巴瘤并肠套叠,行空气灌肠后复发肠套叠,急诊剖腹探查,术中见回肠套入盲肠,盲肠内触及肿物,术中诊断:回盲型肠套叠;盲肠肿物。复位套叠肠管,行病变肠管扩大切除 肠吻合术,切取回盲部淋巴结3枚及病变肠管一同送病理活组织检查,病理结果诊断为Burkitt淋巴瘤,肠管切缘及淋巴结未见累及。术后患儿接受化疗,脑脊液检查、PET/CT均未发现肿瘤病灶。本文结合此病例复习相关文献并进行总结,为临床诊治提供依据。
Burkitt lymphoma is a rare malignant tumor that occurs in childhood. Primary Burkitt lymphoma in the gastrointestinal tract often presents with nonspecific symptoms, making early detection challenging. Some children may develop secondary intussusception due to intestinal tumors, leading to corresponding clinical symptoms and seeking medical attention. This article reports a case of Burkitt lymphoma in the ileocecal region complicated by intussusception in a child. The patient was admitted for intermittent abdominal pain lasting for a week. Ultrasonography suggested ileocecal lymphoma with intussusception. After recurrence of intussusception following air enema, emergency laparotomy was performed. Intraoperatively, intussusception of the ileum into the cecum was found, with a palpable mass in the cecum. The intraoperative diagnosis was ileocecal intussusception and cecal mass. Reduction of the intussuscepted bowel followed by segmental resection and anastomosis was performed. Three ileocecal lymph nodes and the involved bowel segment were sent for pathological examination, which confirmed Burkitt lymphoma without involvement of surgical margins and lymph nodes. The patient underwent postoperative chemotherapy, with negative findings for tumor foci in cerebrospinal fluid and post-chemotherapy whole-body PET-CT scans. This case is presented along with a review of relevant literature to provide a basis for clinical diagnosis and treatment.
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