Loja Oropeza David, Alvizuri Escobedo José, Vilca Vásquez Maricela, Sánchez Mercado Mario
Departamento de Medicina Interna, Hospital Arzobispo Loayza, Lima, Peru.
Rev Gastroenterol Peru. 2002 Jul-Sep;22(3):248-52.
We present the clinical case of a patient with vascular compression of the duodenum or superior mesenteric artery compression syndrome.A female, 42 years old, with history of two months' evolution characterized by postprandial epigastric colic, without irradiation, accompanied by nausea and intractable vomiting, weight loss and gastric shaking. A double contrast gastric duodenum x-ray showed the duodenal frame with exaggerated dilatation and stenosis close to the Treitz angle, through which the contrast media barely flowed. The endoscopy revealed duodenal obstruction, gastric retention and erosive esophagitis. The computerized tomography identified a significant dilatation of the duodenal arc, with stenosis on the aorto-mesenteric junction. We performed an exploratory laparotomy, making a latero-lateral duodenojejunal trans-mesocolic anastomosis. Satisfactory evolution and discharge without complications.
我们报告一例十二指肠血管压迫或肠系膜上动脉压迫综合征患者的临床病例。一名42岁女性,病程两个月,特征为餐后上腹部绞痛,无放射痛,伴有恶心、顽固性呕吐、体重减轻和胃振水音。胃十二指肠双重对比造影X线显示十二指肠框明显扩张,靠近Treitz角处狭窄,造影剂几乎无法通过。内镜检查发现十二指肠梗阻、胃潴留和糜烂性食管炎。计算机断层扫描显示十二指肠弓明显扩张,主动脉-肠系膜交界处狭窄。我们进行了剖腹探查术,做了侧侧十二指肠空肠经结肠系膜吻合术。病情进展顺利,出院时无并发症。