WARNER H A, KINNEAR D G, CAMERON D G
Can Med Assoc J. 1963 Jan 12;88(2):71-4.
Volvulus of the intestine has recently been observed in three patients with idiopathic steatorrhea in relapse. Two patients gave a history of intermittent abdominal pain, distension and obstipation. Radiographic studies during these attacks revealed obstruction at the level of the sigmoid colon. Reduction under proctoscopic control was achieved in one instance, spontaneous resolution occurring in the other. The third patient presented as a surgical emergency and underwent operative reduction of a small intestinal volvulus. Persistence of diarrhea and weight loss postoperatively led to further investigation and a diagnosis of idiopathic steatorrhea. In all cases, treatment resulted in clinical remission with a coincident disappearance of obstructive intestinal symptoms. The pathogenesis of volvulus in sprue is poorly understood. Atonicity and dilatation of the bowel and stretching of the mesentery likely represent important factors. The symptoms of recurrent abdominal pain and distension in idiopathic steatorrhea necessitate an increased awareness of intestinal volvulus as a complication of this disease.
最近在三名复发的特发性脂肪泻患者中观察到肠扭转。两名患者有间歇性腹痛、腹胀和便秘病史。这些发作期间的影像学研究显示乙状结肠水平存在梗阻。其中一例在直肠镜控制下实现了复位，另一例自行缓解。第三名患者以外科急症就诊，接受了小肠扭转的手术复位。术后腹泻和体重减轻持续存在，导致进一步检查并诊断为特发性脂肪泻。在所有病例中，治疗均导致临床缓解，同时梗阻性肠道症状消失。口炎性腹泻中肠扭转的发病机制尚不清楚。肠张力缺乏和扩张以及肠系膜拉伸可能是重要因素。特发性脂肪泻中反复出现的腹痛和腹胀症状需要提高对肠扭转作为该病并发症的认识。
