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題名 | Neonatal Duplication Cysts of Esophagus Present with Respiratory Distress: A Case Report=新生兒食道雙套囊腫合併呼吸窘迫--病例報告 |
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作者姓名(中文) | 潘仕晉; 陳志程; 郭昶宏; 洪志興; | 書刊名 | 安泰醫護雜誌 |
卷期 | 15:4 2009.12[民98.12] |
頁次 | 頁241-248 |
分類號 | 417.517 |
關鍵詞 | 食道雙套囊腫; 呼吸窘迫; 多切面電腦斷層掃描; Esophageal duplication cysts; Respiratory distress; MDCT; |
語文 | 英文(English) |
中文摘要 | 一名足月產男嬰經由剖腹產出生後合併有呼吸窘迫及低體重,經內科治療復症狀改善了,但胸部X光的右上肺野陰影仍在。經由多切面電腦斷層掃描證實了食道雙套囊腫。這種先天性異常並不常見,通常是胚胎發育異常所造成。食道雙套囊腫好發於縱隔後方,最常以球囊狀形式存在,其次是管狀。壓迫到附近的器官常引起呼吸及消化道的症狀。此名男嬰的囊腫是以混合囊狀及管狀的形式存在於縱隔前方。由於有感染、出血、破洞甚至轉變為惡性的危險因子,有些文獻認為應該儘早以手術治療;但另外一些文獻則認為有症狀再切除。本例未接受手術治療。經過二年追蹤這個嬰兒健康情形良好,生長發育亦正常。我們強調當一名新生兒有呼吸窘迫的症狀時,也應考慮食道雙套囊腫這一些不常見的病因。 |
英文摘要 | A full-term male neonate presented with low body weight, respiratory distress and poor activity after delivery via cesarean section. After medical treatments, respiratory distress improved gradually. However, pulmonary alveolar consolidation over right upper lobe on chest X-ray persisted. Following chest X-ray revealed air-contented structure over mediastinum and right pericardial regions. Esophageal duplications were further confirmed by MDCT (multi-detector computed tomography) - reconstructed 3-D images. Esophageal duplication cysts are uncommon congenital anomalies which often result from abnormal embryological developments. The cysts are generally found in posterior mediastinal region. The spherical cystic form is the most common presentation of the esophageal duplications, followed by tubular form. Compression on organs results in respiratory or gastrointestinal symptoms. Our case presented with combined cystic and tubular forms of esophageal duplications over anterior mediastinal region. Although early surgical intervention has been recommended in some literatures according to the risks of malignant changes and other complications as infection, ulceration, bleeding or perforation; some literatures suggest surgical treatment should be delayed until the presence of symptoms. Our case did not receive surgical intervention. After 2-year follow-up, the infant was in good health with normal growth and development. We emphasized that esophageal duplication cysts should be taken into consideration as uncommon causes in a neonate with respiratory distress. |
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