Habib E, Elhadad A
Service de chirurgie viscérale et thoracique, hôpital Robert-Ballanger, 93602, Aulnay-Sous-Bois, France.
Ann Chir. 2003 Mar;128(2):94-7. doi: 10.1016/s0003-3944(02)00037-8.
During embryogenesis, abnormal adhesion of the peritoneal folds induces a congenital band which can cause small bowel obstruction.
From 1987 to 2001, 16 adult patients underwent surgery for small bowel obstruction due to a congenital band. There were 8 men and 8 women with a mean age of 59 years (range 23-90). None presented previous abdominal surgery.
Six patients presented acute abdominal pain the month before hospitalization. Among the 16 patients, 9 were operated at admission, and 7 after initial surveillance. Suspected diagnosis before operation was small bowel obstruction in 8 cases (with a diagnosis of congenital band in 3); perforated duodenal ulcer (n = 2); appendicitis (n = 2); mesenteric infarction (n = 1); diverticultis (n = 1); cholecystitis (n = 1); and strangulated hernia (n = 1). During operation performed through laparotomy or laparoscopy, a congenital band was noted in 100% of the cases, associated with intestinal necrosis in 5. One patient died postoperatively.
Because small bowel obstruction by congenital band is a rare condition, it represents a frequent problem of diagnosis. In this situation, the possibility of intestinal necrosis expose the patient to a possible fatal outcome.
在胚胎发育过程中，腹膜皱襞的异常粘连会诱发先天性束带，进而导致小肠梗阻。
1987年至2001年期间，16例成年患者因先天性束带导致小肠梗阻而接受手术。其中男性8例，女性8例，平均年龄59岁（范围23 - 90岁）。所有患者既往均未接受过腹部手术。
6例患者在住院前1个月出现急性腹痛。16例患者中，9例入院时即接受手术，7例经过初步监测后手术。术前疑似诊断为小肠梗阻8例（其中3例诊断为先天性束带）；十二指肠溃疡穿孔（2例）；阑尾炎（2例）；肠系膜梗死（1例）；憩室炎（1例）；胆囊炎（1例）；绞窄性疝（1例）。在通过剖腹手术或腹腔镜手术进行的操作中，100%的病例发现有先天性束带，其中5例伴有肠坏死。1例患者术后死亡。
由于先天性束带导致的小肠梗阻是一种罕见疾病，它是一个常见的诊断难题。在这种情况下，肠坏死的可能性会使患者面临可能的致命后果。
