BMJ:中肠扭转-案例报道

2017-03-25 xing.T MedSci原创

该患者接受急诊开腹手术,进行Ladd’s术式,病人的症状缓解。而中肠肠扭转是肠旋转不良的并发症,它在成人患者中很少第一时间表现为腹痛。

患者为一名56岁的老年男性,没有手术病史,因出现急性胃溃疡和恶心而就诊。该患者数月来经历了吃饭后发生发作性胃黏膜疼痛,但上消化道内镜检查未见异常。

体格检查发现弥漫性腹部压痛伴反跳痛。对比增强计算机断层扫描(如图1所示)显示肠系膜逆时针扭转,包绕肠系膜上动脉。


图1

这个临床表现被称为漩涡征,该征提示为中肠肠扭转。

该患者接受急诊开腹手术,进行Ladd’s术式,病人的症状缓解。而中肠肠扭转是肠旋转不良的并发症,它在成人患者中很少第一时间表现为腹痛。

原始出处:

Takeshi Kondo. et al. Midgut volvulus. BMJ2017;356:i6782 doi: 10.1136/bmj.i6782 

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    2017-12-23 gaoxiaoe
  2. [GetPortalCommentsPageByObjectIdResponse(id=1848271, encodeId=210918482e1c1, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Sat Dec 23 03:12:00 CST 2017, time=2017-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183651, encodeId=594a183651cb, content=学习了少见疾病, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3ibz8CYT5b0zyDiasBqB9iaBNmoAnltag9pJoPmiacnibTMS4y6wnSXsibl2wHn1fed1RMiaF3elh76pbNP1j2LiaSks8S/0, createdBy=09681927734, createdName=1e0c1443m21(暂无匿称), createdTime=Thu Mar 30 03:25:22 CST 2017, time=2017-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182651, encodeId=c41e182651d9, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLOjYpNibV8roJT2XMscxtlnBajcUrmvMcA7NibSk4mK4KAicMAjyKwBLXOJQ6wHCibFtX6G3CkJ4QD1E/0, createdBy=1ebb2041769, createdName=Dr.王贺, createdTime=Sat Mar 25 14:40:45 CST 2017, time=2017-03-25, status=1, ipAttribution=)]
    2017-03-30 1e0c1443m21(暂无匿称)

    学习了少见疾病

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1848271, encodeId=210918482e1c1, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Sat Dec 23 03:12:00 CST 2017, time=2017-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=183651, encodeId=594a183651cb, content=学习了少见疾病, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3ibz8CYT5b0zyDiasBqB9iaBNmoAnltag9pJoPmiacnibTMS4y6wnSXsibl2wHn1fed1RMiaF3elh76pbNP1j2LiaSks8S/0, createdBy=09681927734, createdName=1e0c1443m21(暂无匿称), createdTime=Thu Mar 30 03:25:22 CST 2017, time=2017-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182651, encodeId=c41e182651d9, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLOjYpNibV8roJT2XMscxtlnBajcUrmvMcA7NibSk4mK4KAicMAjyKwBLXOJQ6wHCibFtX6G3CkJ4QD1E/0, createdBy=1ebb2041769, createdName=Dr.王贺, createdTime=Sat Mar 25 14:40:45 CST 2017, time=2017-03-25, status=1, ipAttribution=)]
    2017-03-25 Dr.王贺

    了解

    0

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