Surgical management of intestinal malrotation in adults
Surgical management of intestinal malrotation in adults
复制标题
DOI：
10.1007/s00268-007-9018-2
复制
发表时间：
2007-09-01
影响因子：
2.6
通讯作者：
Liu, Bao Hua
中科院分区：
文献类型：
--
作者：
Fu, Tao;Tong, Wei Dong;Liu, Bao Hua
目的总结成人肠旋转不良的诊断和手术治疗经验。方法回顾性分析成人肠旋转不良的手术治疗效果。1996年7月至2006年7月期间观察并治疗了12例患者（4例女性和8例男性;患者的平均年龄为28.5岁）。手术结果，包括术后并发症，死亡，和术前症状的解决，measured.Results的诊断旋转不良术前在5例上消化道造影研究，钡灌肠，或计算机断层扫描。7例患者在剖腹手术时偶然发现异常。术中均证实为旋转不良。9例患者接受剖腹手术，3例患者接受腹腔镜手术（1例转为开放手术）。随访2 ~ 118个月。3例患者出现并发症：1例伤口感染，1例胃排空延迟，1例发生粘连性肠梗阻。仅检测到2例复发，1例复发患者需要再次手术。结论肠旋转不良是成人腹痛的一种罕见但重要的原因。它可能出现慢性或急性症状。开腹手术和腹腔镜手术是治疗成人肠旋转不良的替代和可行的技术，并发症发生率低。
Objective The aim of this study was to review our experience with diagnosis and surgical management of intestinal malrotation in adult patients.Patients and Methods A retrospective review of the surgical outcome of adults with intestinal malrotation was performed. Twelve patients were observed and treated between July 1996 and July 2006 (4 women and 8 men; the mean age of the patients was 28.5 years). Surgical outcomes, including postoperative complications, deaths, and resolution of preoperative symptoms, were measured.Results A diagnosis of malrotation was made preoperatively in five patients by upper gastrointestinal contrast study, barium enema, or computed tomography scan. The anomaly was discovered incidentally at laparotomy in seven patients. All cases were proved to be malrotation intraoperatively. Nine patients underwent laparotomy and three underwent laparoscopic surgery (one converted to an open procedure). Follow-up ranged from 2 months to 118 months. Three patients had complications: one had wound infection, one had delayed gastric emptying, and one developed adhesive ileus. There were only two recurrences detected and one patient with recurrence required reoperation. No one died.Conclusions Intestinal malrotation is a rare but important cause of abdominal pain in adults. It may present with chronic or acute symptoms. Laparotomy and laparoscopy are alternative and feasible techniques with low rates of complications for the treatment of intestinal malrotation in adults.