小儿胆囊息肉样病变的临床与病理

目的了解小儿胆囊息肉样病变的临床表现和病理特征。方法对12例小儿胆囊息肉样病变的临床和病理分类进行分析。结果均有右上腹痛、恶心、食欲差。胆系X线造影：7例显示慢性胆囊炎，2例胆囊结石。B超：10例在增厚胆囊壁有小隆起回声，2例有结石。CT：10例在胆囊内有小占位病变。12例胆囊摘除后均治愈。病理分类：胆固醇性息肉样病变5例，炎性息肉3例，腺肌增生症2例，腺肌瘤、腺癌各1例。8例有R－A窦形成，其中2例增生的R－A窦形成腺肌增生症。结论本病的形成与慢性胆囊炎与胆囊结石有关。慢性胆囊炎使胆囊粘膜形成R－A窦。R－A窦促使发生息肉样病变。R－A窦促使发生腺肌增生症，为胆囊癌的癌前病变。大于1．0cm的息肉样病变胆囊摘除为首选治疗。

Clinical feature and pathomorphology of polypoid lesion of gall-bladder in children

To investigate the clinical feature and pathomor phology of polypoid lesion of gallbladder in children. Methods Twelve cases of polypoid lesion of gallbladder in children were observed in this study.Results Abdominal pain, anorexia, nausea and vomiting were found in all patients. Ultrasonography: the hyperechoic shadows of small protuberance on thickened wall of the gallbladders were found in 10 cases. CT scanning showed occupied focus in gallbladders in 10 case.12 patients were cured without any complication after the removal of gallbladder. Pathohistological classifications were as follows: cholesterol polypoid lesions in 5 cases , infective polypoid lesions in 3 cases. Adenomyomatosis in 2 and adenomatous carcinoma in 1. On sections, Rokitansky-Aschoff sinuses were clearly observed in 8 cases.Conclusions B-Ultrasonography and CT scanning are useful for the diagnosis of polypoid lesion of gallbladder in children. We suggest that R-A sinus may formed polypoid lesion of gallbladder and R-A sinus may be the origin of carcinoma of gallbladder. Cholecystectomy is the choice of polypoid lesion of gallbladder if the size is larger than 10mm in diameter.