全直肠结肠切除术及回肠J袋肛管吻合术治疗伴有粪块阻塞的恰加斯病性巨结肠：病例报告

Total proctocolectomy and ileal J-pouch anal anastomosis for chagasic megacolon with fecaloma: report of a case.

作者信息

Araki Toshimitsu, Miki Chikao, Yoshiyama Shigeyuki, Toiyama Yuji, Sakamoto Naoko, Kusunoki Masato

机构信息

Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.

出版信息

Surg Today. 2006;36(3):277-9. doi: 10.1007/s00595-005-3140-2.

DOI:10.1007/s00595-005-3140-2

PMID:16493541

Abstract

Megacolon, resulting in severe constipation, is one of the most common manifestations of Chagas' disease. We herein report a case of megacolon with fecaloma in a 39-year-old Brazilian man who presented with severe constipation. He underwent a total proctocolectomy and ileal J-pouch anal anastomosis. Histologically, there was a marked thickening of the proper muscle layer, and a moderate decrease in the myoenteric nerve plexuses and neurons in the megacolon area. A feasible outcome has been achieved after a 1-year follow-up. A total proctocolectomy with ileal J-pouch anal anastomosis may therefore be one of the useful strategies for the surgical treatment of patients with chagasic megacolon.

摘要

巨结肠导致严重便秘，是恰加斯病最常见的表现之一。我们在此报告一例39岁巴西男性的巨结肠伴粪石症病例，该患者表现为严重便秘。他接受了全直肠结肠切除术及回肠J形贮袋肛管吻合术。组织学检查显示，固有肌层明显增厚，巨结肠区域的肌间神经丛和神经元中度减少。随访1年后取得了可行的结果。因此，全直肠结肠切除术及回肠J形贮袋肛管吻合术可能是治疗恰加斯病性巨结肠患者的有效手术策略之一。