Nemoto Hiroshi, Yoshizawa Yasuo, Hibi Kenji, Saito Mitsuo, Ishibashi Kazuyoshi, Sanada Yutaka, Tate Genshu
Department of Surgery, Showa University Fujigaoka Hospital, Yokohama, Japan.
Case Rep Gastroenterol. 2008 Jul 1;2(2):214-8. doi: 10.1159/000135609.
While many recent cases of colonic epiploic appendage causing acute abdomen have been reported, such appendages of the small bowel are extremely rare. We present a 59-year-old woman in whom a small bowel epiploic appendage caused volvulus. She presented with abdominal pain and vomiting in the absence of previous abdominal operations. A diagnosis of small bowel obstruction from strangulation was made. Laparotomy disclosed bloody peritoneal fluid and a closed loop of strangulated small intestine. An adherent band composed of an epiploic appendage and intestine had completely encircled a loop of jejunum, leading to obstruction. This band was released, and approximately 80 cm of gangrenous bowel was resected. Four epiploic appendages 5-6 cm in length were attached to the ileum at the mesenteric border, beginning at a point 70 cm proximal to the terminal ileum.
虽然最近已有许多关于结肠系膜缘垂引起急腹症的病例报道，但小肠的此类系膜缘垂极为罕见。我们报告一名59岁女性，其小肠系膜缘垂导致肠扭转。她在既往无腹部手术史的情况下出现腹痛和呕吐。诊断为绞窄性小肠梗阻。剖腹探查发现血性腹腔积液及一段绞窄的小肠闭袢。一条由系膜缘垂和肠管组成的粘连带完全环绕了一段空肠，导致梗阻。松解该粘连带，并切除约80cm坏死肠管。在距回肠末端70cm处的肠系膜缘，有4条长5 - 6cm的系膜缘垂附着于回肠。
