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儿童双侧阴道突未闭伴乳糜性积液一例:罕见病例报告及文献复习

 

Authors Tao C , Cao Y

Received 16 October 2024

Accepted for publication 26 November 2024

Published 27 November 2024 Volume 2024:17 Pages 9917—9923

DOI https://doi.org/10.2147/JIR.S499301

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Professor Ning Quan

Chengpin Tao, Yongsheng Cao

Pediatric Urology Department, Anhui Provincial Children’s Hospital, Hefei, Anhui, People’s Republic of China

Correspondence: Chengpin Tao, Pediatric Urology Department, Anhui Provincial Children’s Hospital, No. 39 Wangjiang East Road, Hefei, Anhui, 230000, People’s Republic of China, Email taochengpin@163.com

Background: Chylous effusion is a rare condition characterized by the accumulation of lymphatic fluid in body cavities, often due to trauma, malignancy, or congenital lymphatic abnormalities. The association of chylous effusion with a patent processus vaginalis (PV) in pediatric patients is exceptionally uncommon, presenting unique diagnostic and therapeutic challenges.
Objective: To report a rare case of bilateral patent processus vaginalis with chylous effusion in a pediatric patient, detailing the diagnostic process, surgical management, and outcomes, while contributing to the limited literature on this condition.
Methods: A 1-year-10-month-old male presented with a left inguinal-scrotal swelling. Ultrasonography suggested a hydrocele. Laparoscopic exploration revealed bilateral patent PVs with chylous fluid in the abdominal cavity and tunica vaginalis. The fluid was aspirated and analyzed, confirming chylous effusion. Bilateral high ligation of the PV was performed, and the patient was initially managed with a specialized diet.
Results: The patient underwent successful laparoscopic bilateral high ligation of the PVs with complete resolution of symptoms. Follow-up ultrasonography at one week, one month, and three months post-surgery showed no evidence of fluid accumulation or hydrocele recurrence.
Conclusion: Bilateral patent processus vaginalis with chylous effusion is an extremely rare condition in pediatric patients. This case demonstrates that early surgical intervention with laparoscopic high ligation can effectively resolve the condition without the need for prolonged dietary modifications. Further documentation of similar cases is necessary to better understand and manage this rare clinical presentation.

Keywords: patent processus vaginalis, chylous effusion, pediatric surgery, laparoscopic surgery, hydrocele