Salonen I S, Mäkinen E
Ann Chir Gynaecol. 1976;65(1):38-45.
A follow-up study of 27 children operated for congenital duodenal obstruction (CDO) in the years 1953--71 is presented. Nine children belonged to the intrinsic and 18 children to the extrinsic group of CDO. A total of 7 retrocolic, isoperistaltic, side-to-side duodeno-jejunostomy, 7 Ladd's operation, 8 duodenolysis, 2 reduction of midgut volvulus, 2 duodenostomy a.m. Morton and one gastro-jejunostomy were performed at the age of 1 day--15 years. The clinical and radiological examinations were performed 3--21 years (mean 10 years 2 months) after these operations. In 3 cases there was a moderate duodenal dilatation, but reoperation was not necessary. During the follow-up period, one boy, now aged 8 years, developed a blind pouch-syndrome in the I portion of the duodenum containing a 5 x 5 cm phytobezoar 4 1/2 years after duodeno-jejunostomy. The frequency of blind pouch-syndrome after duodeno-jejunostomy was thus 1:7 or 14%. One girl, now aged 9 years, developed a blind loop-syndrome in the ileocaecal segment 3 months after side-to-side ileotransversostomy, which was performed from adhesion-obstruction after duodenolysis for malrotation I and CDO. Both the blind pouch- and the blind loop-deformation were resected and the children recovered well. To avoid blind-pouch- and blind loop-deformations in the intestines, the anastomosis must be made wide enough, and especially in the surgery of the jejuno-ileo-colic region an end-to-end anastomosis is preferable.
本文介绍了一项对1953年至1971年间接受先天性十二指肠梗阻（CDO）手术的27名儿童的随访研究。9名儿童属于CDO的内在型组，18名儿童属于外在型组。在1天至15岁时，共进行了7例结肠后、顺蠕动、侧侧十二指肠空肠吻合术，7例Ladd手术，8例十二指肠松解术，2例中肠扭转复位术，2例Morton上午十二指肠造口术和1例胃空肠吻合术。这些手术后3至21年（平均10年2个月）进行了临床和放射学检查。3例有中度十二指肠扩张，但无需再次手术。在随访期间，一名现年8岁的男孩在十二指肠空肠吻合术后4年半，十二指肠I段出现盲袋综合征，其中含有一个5×5厘米的植物性粪石。因此，十二指肠空肠吻合术后盲袋综合征的发生率为1:7或14%。一名现年9岁的女孩在侧侧回肠横结肠吻合术后3个月，在回盲部出现盲袢综合征，该手术是因十二指肠松解术后粘连梗阻而行，原因是旋转不良I型和CDO。盲袋和盲袢畸形均被切除，患儿恢复良好。为避免肠道出现盲袋和盲袢畸形，吻合口必须足够宽，尤其是在空肠-回肠-结肠区域的手术中，端端吻合更为可取。
