MIDGUT VOLVULUS AS A COMPLICATION OF INTESTINAL MALROTATION IN ADULTS
MIDGUT VOLVULUS AS A COMPLICATION OF INTESTINAL MALROTATION IN ADULTS
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DOI：
10.1007/bf01316496
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发表时间：
1993-03-01
影响因子：
3.1
通讯作者：
LU, CC
中科院分区：
文献类型：
--
作者：
FUKUYA, T;BROWN, BP;LU, CC
本文报告7例成人中肠扭转为旋转不良的并发症。所有患者均为男性，平均年龄33岁。其中4人有长期间歇性腹痛病史。在三例患者中，在上胃肠道序列中，在十二指肠和空肠近端出现扭曲的、螺旋状的钡柱作为诊断的依据。在剩余的患者中，术前三年的小肠随访显示肠道旋转不良。3例患者表现为急性发作的剧烈腹痛。2例患者平片表现为小肠梗阻和肠性肺积症，3例患者仅表现为几乎完全的小肠梗阻。由于需要进行剖腹探查和穿孔的风险，本组未进行钡剂检查。在一名患者中，腹部血管造影显示肠系膜血管向小肠弯曲段的异常路线提示诊断。这三例患者在剖腹手术时均出现肠段缺血。
Seven adults with midgut volvulus as a complication of malrotation are presented. All patients were men with an average age of 33 years. Four presented with long histories of intermittent abdominal pain. In three patients, the twisted, corkscrew appearance of the barium column in the duodenum and proximal jejunum in an upper gastrointestinal series made the diagnosis. In the remaining patient, small-bowel follow-through performed three years before surgery showed intestinal malrotation. Three patients presented with the acute onset of severe abdominal pain. Plain films showed small-bowel obstruction and pneumatosis intestinalis in two patients and only nearly complete small-bowel obstruction in the third. Barium studies were not done in this group because of the need to proceed to exploratory laparotomy, and the risk of perforation. In one patient, abdominal angiography suggested the diagnosis by showing abnormal courses of the mesenteric vessels to the volvulized segment of small bowel. All three of these patients showed ischemic segments of bowel at laparotomy.