腹腔镜十二指肠空肠吻合术治疗肠系膜上动脉综合征
Laparoscopic duodenojejunostomy for superior mesenteric artery syndrome.
作者信息
Palanivelu Chinnusamy, Rangarajan Muthukumaran, Senthilkumar Rangaswamy, Parthasarathi Ramakrishnan, Jani Kalpesh
机构信息
GEM Hospital, Ramnathapuram, Coimbatore, India.
出版信息
JSLS. 2006 Oct-Dec;10(4):531-4.
BACKGROUND
Superior mesenteric artery (Wilkie's) syndrome is a rare condition. Only 400 cases have been reported so far. The symptoms may be acute or chronic, the chronic form being more common. Vomiting is the most common symptom. About 15 causal factors have been found. Conservative management is the rule for acute cases. Surgery is indicated for chronic cases and failure of conservative management. Laparoscopy has been used in only 8 cases so far.
CASE REPORT
We report the ninth case of superior mesenteric artery syndrome managed by laparoscopic duodenojejunostomy. The patient was a 14-year-old boy with chronic symptoms since childhood. The procedure was relatively straightforward. The case is being reported for its rarity and the possibility of laparoscopic management.
DISCUSSION
Laparoscopic severing of Treitz's ligament is another surgical option, though gastrojejunostomy is of no use. Conservative management is useful only in acute cases.
CONCLUSION
Duodenojejunostomy is the procedure of choice and is effective in 90% of patients. We conclude that it is very effective in this condition, especially laparoscopically.
背景
肠系膜上动脉（威尔基氏）综合征是一种罕见病症。迄今为止仅报告了400例。症状可能是急性的或慢性的，慢性形式更为常见。呕吐是最常见的症状。已发现约15种致病因素。急性病例通常采用保守治疗。慢性病例以及保守治疗失败时则需进行手术。迄今为止，腹腔镜手术仅应用于8例。
病例报告
我们报告了第9例通过腹腔镜十二指肠空肠吻合术治疗的肠系膜上动脉综合征病例。该患者是一名14岁男孩，自幼便有慢性症状。手术过程相对简单。报告该病例是因其罕见性以及腹腔镜治疗的可能性。
讨论
腹腔镜下切断屈氏韧带是另一种手术选择，尽管胃空肠吻合术并无用处。保守治疗仅对急性病例有用。
结论
十二指肠空肠吻合术是首选术式，90%的患者有效。我们得出结论，该术式对此病症非常有效，尤其是腹腔镜手术。
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