NEJM:空肠憩室所致的肠系膜扭转-病例报道

2020-06-26 MedSci原创 MedSci原创

在探查性手术期间,发现Treitz韧带下方30厘米至130厘米处有空肠憩室,该憩室导致肠系膜肠扭转。

患者为一名没有明显病史的75岁男子,因腹部痉挛和呕吐12小时而到急诊就诊。

体格检查发现腹部胀痛有压痛,但没有反弹痛或肌紧张。鼻胃减压可获得胆汁性胃内容物。腹部计算机断层扫描显示“旋转体征”,提示中肠肠系膜肠扭转(如图A所示)。在探查性手术期间,发现Treitz韧带下方30厘米至130厘米处有空肠憩室,该憩室导致肠系膜肠扭转(如图B所示)。

该患者接受了切除小肠的Ladd手术,去除了空肠憩室并留下了约400 cm长的残留肠。手术后第3天开始通过空肠造口管进行肠内喂养,并在术后第5天开始口服喂养。

患者在术后第8天出院,成功出院后21天将空肠造口管拔出,过渡到口服喂养。

原始出处:

Wan-Yu Hung,et al.Mesenteric Volvulus from Jejunal Diverticulosis.N Engl J Med 2020;https://www.nejm.org/doi/full/10.1056/NEJMicm1911732

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1193119, encodeId=87e81193119fa, content=东西很多,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eouShoVRPZvFshog2V4Bs8JhDIybaiaNUp16CYicwfDeRB6KoOUPj3fibYhRSsWDJ2LGJM8fFQVIrdnQ/132, createdBy=f44f2325690, createdName=苏新攀, createdTime=Sun Feb 13 22:18:06 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1522749, encodeId=ee151522e4993, content=<a href='/topic/show?id=14d853e8918' target=_blank style='color:#2F92EE;'>#憩室#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53789, encryptionId=14d853e8918, topicName=憩室)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=33b211483971, createdName=zutt, createdTime=Sun Jun 28 12:45:26 CST 2020, time=2020-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557267, encodeId=3205155e26760, content=<a href='/topic/show?id=d5e281610db' target=_blank style='color:#2F92EE;'>#肠系膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81610, encryptionId=d5e281610db, topicName=肠系膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f84f14890130, createdName=zzc2216, createdTime=Sun Jun 28 12:45:26 CST 2020, time=2020-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035325, encodeId=55ca103532541, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat Jun 27 00:45:26 CST 2020, time=2020-06-27, status=1, ipAttribution=)]
    2022-02-13 苏新攀

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1193119, encodeId=87e81193119fa, content=东西很多,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eouShoVRPZvFshog2V4Bs8JhDIybaiaNUp16CYicwfDeRB6KoOUPj3fibYhRSsWDJ2LGJM8fFQVIrdnQ/132, createdBy=f44f2325690, createdName=苏新攀, createdTime=Sun Feb 13 22:18:06 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1522749, encodeId=ee151522e4993, content=<a href='/topic/show?id=14d853e8918' target=_blank style='color:#2F92EE;'>#憩室#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53789, encryptionId=14d853e8918, topicName=憩室)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=33b211483971, createdName=zutt, createdTime=Sun Jun 28 12:45:26 CST 2020, time=2020-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557267, encodeId=3205155e26760, content=<a href='/topic/show?id=d5e281610db' target=_blank style='color:#2F92EE;'>#肠系膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81610, encryptionId=d5e281610db, topicName=肠系膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f84f14890130, createdName=zzc2216, createdTime=Sun Jun 28 12:45:26 CST 2020, time=2020-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035325, encodeId=55ca103532541, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat Jun 27 00:45:26 CST 2020, time=2020-06-27, status=1, ipAttribution=)]
    2020-06-28 zutt
  3. [GetPortalCommentsPageByObjectIdResponse(id=1193119, encodeId=87e81193119fa, content=东西很多,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eouShoVRPZvFshog2V4Bs8JhDIybaiaNUp16CYicwfDeRB6KoOUPj3fibYhRSsWDJ2LGJM8fFQVIrdnQ/132, createdBy=f44f2325690, createdName=苏新攀, createdTime=Sun Feb 13 22:18:06 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1522749, encodeId=ee151522e4993, content=<a href='/topic/show?id=14d853e8918' target=_blank style='color:#2F92EE;'>#憩室#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53789, encryptionId=14d853e8918, topicName=憩室)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=33b211483971, createdName=zutt, createdTime=Sun Jun 28 12:45:26 CST 2020, time=2020-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557267, encodeId=3205155e26760, content=<a href='/topic/show?id=d5e281610db' target=_blank style='color:#2F92EE;'>#肠系膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81610, encryptionId=d5e281610db, topicName=肠系膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f84f14890130, createdName=zzc2216, createdTime=Sun Jun 28 12:45:26 CST 2020, time=2020-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035325, encodeId=55ca103532541, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat Jun 27 00:45:26 CST 2020, time=2020-06-27, status=1, ipAttribution=)]
    2020-06-28 zzc2216
  4. [GetPortalCommentsPageByObjectIdResponse(id=1193119, encodeId=87e81193119fa, content=东西很多,值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eouShoVRPZvFshog2V4Bs8JhDIybaiaNUp16CYicwfDeRB6KoOUPj3fibYhRSsWDJ2LGJM8fFQVIrdnQ/132, createdBy=f44f2325690, createdName=苏新攀, createdTime=Sun Feb 13 22:18:06 CST 2022, time=2022-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1522749, encodeId=ee151522e4993, content=<a href='/topic/show?id=14d853e8918' target=_blank style='color:#2F92EE;'>#憩室#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53789, encryptionId=14d853e8918, topicName=憩室)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=33b211483971, createdName=zutt, createdTime=Sun Jun 28 12:45:26 CST 2020, time=2020-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1557267, encodeId=3205155e26760, content=<a href='/topic/show?id=d5e281610db' target=_blank style='color:#2F92EE;'>#肠系膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81610, encryptionId=d5e281610db, topicName=肠系膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f84f14890130, createdName=zzc2216, createdTime=Sun Jun 28 12:45:26 CST 2020, time=2020-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035325, encodeId=55ca103532541, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat Jun 27 00:45:26 CST 2020, time=2020-06-27, status=1, ipAttribution=)]
    2020-06-27 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0