Department of General Surgery, Princess Royal University Hospital, Orpington, Kent, BR6 8ND, UK.
World J Emerg Surg. 2007 Aug 15;2:20. doi: 10.1186/1749-7922-2-20.
Very few cases of small bowel obstruction due to ingested fruits have been described in literature, and most of these have managed by a laparotomy. Laparoscopic assisted surgery can effectively deal with such impacted foreign bodies, thereby avoiding a formal laparotomy.
A 75 years old lady was admitted via the Accident and Emergency to the surgical ward with a three-day history of abdominal pain and vomiting. Investigations were suggestive of acute small bowel obstruction. On laparoscopy, there was an area of sudden change in calibre of small bowel with dilated proximal and collapsed distal segment in distal jejunum. A foreign body, dried undigested apricot, was extracted by mini-laparotomy.
Small bowel obstruction is a frequent cause of emergency surgery, and aetiology may include food bolus obstruction. Diagnosis is usually confirmed intra-operatively. Foreign body impacted in small bowel can be removed by open or laparoscopic methods.
Generally, laparotomy is performed for diagnosis and management in acute bowel obstruction, but with increasing expertise, laparoscopy can be equally effective with all the other advantages of minimal access approach.
文献中很少有因吞食水果而导致小肠梗阻的病例,而且这些病例大多通过剖腹手术治疗。腹腔镜辅助手术可以有效地处理这些嵌塞的异物,从而避免进行正式的剖腹手术。
一位 75 岁的女士因腹痛和呕吐三天而被紧急送往外科病房。检查提示急性小肠梗阻。腹腔镜检查显示小肠的一个部位突然变细,远端空肠的近端扩张而远端塌陷。通过小切口取出了一个异物,即未消化的干杏仁。
小肠梗阻是急诊手术的常见原因,病因可能包括食物团块梗阻。通常在术中确诊。嵌塞在小肠内的异物可以通过开腹或腹腔镜方法取出。
一般来说,剖腹手术是急性肠梗阻的诊断和治疗方法,但随着专业技术的提高,腹腔镜手术同样有效,且具有微创方法的所有其他优点。