兒童腹部淋巴管瘤：一病例報告

Childhood Abdominal Cystic Lymphangioma: Report of One Case

腹部淋巴管瘤為一種少見的淋巴血管異常，主要發生在兒童。最常發生的位置在腸系膜，其次是在後腹腔。我們經歷一位兩歲五個月大的小男孩因為經常含膽汁的嘔吐及陣發性腹痛而住院，腹部X光僅顯示胃部輕微腫脹而腹部超音波顯示在右側腹部中央有一囊狀腫塊，腹部電腦斷層檢查顯示右下腹腔有一多腔室囊腫。剖腹探查手術發現在空腸腸系膜上有一多腔室囊腫，將病灶（囊腫、腸系膜及部分腸子）切除後病程平穩，在往後兩年的追蹤病人不再有腹痛及嘔吐之情形。腸系膜淋巴管瘤為引起腸阻塞很少見的原因，臨床上的表現為無症狀意外發現的腹部腫塊至嚴重如腹部急症。腹部超音波及電腦斷層檢查為診斷的依據，治療首選為外科手術完全切除。

Abdominal lymphangiomas are a rare congenital benign vascular malformation of the lymphatic system occurring mainly in childhood [1]. We experienced a case of abdominal cystic lymphangioma in a two years and five months old little boy. He was admitted due to frequent bilious vomiting and paroxysmal abdominal pain. Plain abdominal X-ray revealed distention of stomach. Abdominal ultrasonography (US) revealed a cystic mass with septum over right midabdomen and marked distended stomach. Abdominal computed tomography (CT) showed a loculated hypodensity cystic-like mass over right lower quadrant. A multilobulated cystic mass was found on the mesentery of the jejunum at exploratory laparotomy. The tumor, mesentery, and the involved bowel were resected and the bowel continuity was restored. Postoperative course was uneventful, and there was no more frequent abdominal pain or vomiting in 2-year follow up.