Hsieh Ting-Min, Sheen-Chen Shyr-Ming, Lin Chih-Che
Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung College of Medicine, Chang Gung University, Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan.
Dig Dis Sci. 2008 Nov;53(11):3037-9. doi: 10.1007/s10620-008-0530-5. Epub 2008 Sep 17.
Intussusception is familiar to pediatric surgeons but is rarely encountered by general surgeons. Adult intussusception is uncommon, accounting for less than 5% of intestinal obstructions, half of which are associated neoplasms. Intestinal malrotation is usually an incidental finding with unrelated disease on image studies, laparotomy or even autopsy. The major complications of intestinal malrotation are intestinal obstruction secondary to midgut volvulus, internal hernia, or adhesion band. The association of the two entities, which is named Waugh's syndrome in infants, has rarely been reported in the literature. The association in adults is even rarer. We report an adult case with an unusual combination of malrotation and intussusception at exploration.
肠套叠为小儿外科医生所熟知,但普通外科医生很少遇到。成人肠套叠并不常见,占肠梗阻病例的不到5%,其中一半与肿瘤有关。肠旋转不良通常是在影像学检查、剖腹手术甚至尸检时作为与其他疾病无关的偶然发现。肠旋转不良的主要并发症是中肠扭转、内疝或粘连带继发的肠梗阻。这两种情况的关联在婴儿中称为沃氏综合征,在文献中鲜有报道。在成人中这种关联更为罕见。我们报告1例成人病例,术中发现旋转不良与肠套叠罕见地合并存在。