The role of laparoscopy in the diagnosis and treatment of intestinal duplication in childhood. A report of two cases.

摘要

In children, the diagnostic approach for cystic abdominal tumors (e.g., intestinal duplication) usually includes CT scan, ultrasound (US), and MRI. In small children and babies, the diagnosis is often made by laparotomy. We present our preliminary experience with laparoscopic-assisted surgery (LAS) in two girls. Both children underwent US as the diagnostic approach using imaging techniques. If an intraabdominal mass was identified as cystic or solid, the second step was diagnostic laparoscopy with LAS. One of the girls, a 9-year-old, had a history of appendectomy and abdominal cramps. US revealed a cystic structure in the right lower quadrant. Laparoscopy showed an intestinal duplication, which was mobilized; a segmental small bowel resection was then performed. The second girl, a (6-month-old,) had an antenatal diagnosed cystic mass. A small bowel duplication was found laparoscopically, completely mobilized and excised, and harvested through a small umbilical incision. The postop course was uneventful. In former times, transverse laparotomy and Pfannenstil incision were the most common surgical approaches. LAS combines an excellent means of exploration with the simultaneous performance of definitive surgery. Perfect cosmetic results can be achieved even in children with rare pathology.