van der Voorn Michael M P J A, Oen Patrick R Fa Si
Leids Universitair Medisch Centrum, Rijksuniversiteit Leiden, The Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A921.
An 84-year-old woman was admitted to the emergency department of the St. Elisabeth Hospital in Curaçao for acute diffuse abdominal pain. Her medical history revealed an 'irritable bowel syndrome' with symptoms of chronic progressive abdominal pain. Plain abdominal radiography and computed tomography showed a substantially dilated bowel with torsion of the organ structures and suspected strangulation of the colon. Perioperative examination revealed a distended mobile caecum and right hemicolon. There was also strangulation and herniation of both structures through the foramen of Winslow around the hepatoduodenal ligament, protruding through the minor omentum. After destrangulation and closure of the herniation a caecopexy with an additional appendectomy was performed. Mobile caecum is defined as a failure of the right colon to fuse to the posterior parietal peritoneum. The symptoms of chronic abdominal pain may have been the result of the pre-existing mobile caecum.
一名84岁女性因急性弥漫性腹痛被送往库拉索岛圣伊丽莎白医院急诊科。她的病史显示患有“肠易激综合征”，伴有慢性进行性腹痛症状。腹部平片和计算机断层扫描显示肠道明显扩张，器官结构扭转，怀疑结肠绞窄。围手术期检查发现盲肠和右半结肠扩张且可移动。此外，这两个结构通过肝十二指肠韧带周围的网膜孔发生绞窄和疝出，从小网膜突出。在解除绞窄并关闭疝出部位后，进行了盲肠固定术并附加阑尾切除术。移动盲肠定义为右结肠未能与后腹膜壁层融合。慢性腹痛症状可能是先前存在的移动盲肠所致。
