Arbell Dan, Koplewitz Benjamin, Zamir Gideon, Bala Miklosh
Department of Pediatric Surgery, Hadassah--Hebrew University, Jerusalem, Israel.
J Laparoendosc Adv Surg Tech A. 2007 Jun;17(3):321-3. doi: 10.1089/lap.2006.0102.
Intestinal malrotation is usually encountered in infants. Its main complication is midgut volvulus, a situation that presents itself with bilious vomiting. This symptom allows for early surgical treatment. A delay in diagnosis and treatment may lead to catastrophic sequelae, such as extensive bowel necrosis and death. This situation is rare but well known in adults. Laparoscopic gastric banding is a popular option for treating morbid obesity. One of the consequences of this procedure may be impaired vomiting when there is an obstruction below the band. In this paper, we present a case in which a patient suffered from midgut volvulus 4 years after a laparoscopic gastric banding. Owing to impaired vomiting, the diagnosis was delayed, therefore, severely endangering the patient. This case prompted us to suggest that malrotation should be actively sought after before or during any bariatric procedure.
肠旋转不良通常在婴儿中出现。其主要并发症是中肠扭转，这种情况表现为胆汁性呕吐。该症状有利于早期手术治疗。诊断和治疗的延迟可能导致灾难性后果，如广泛的肠坏死和死亡。这种情况在成年人中罕见但为人所知。腹腔镜胃束带术是治疗病态肥胖的一种常用方法。该手术的后果之一可能是当束带下方出现梗阻时呕吐功能受损。在本文中，我们报告了一例患者在接受腹腔镜胃束带术4年后发生中肠扭转的病例。由于呕吐功能受损，诊断被延迟，从而严重危及患者。该病例促使我们建议在任何减肥手术之前或期间都应积极排查肠旋转不良。
