Yoneda Akira, Kamohara Yukio, Taniguchi Ken, Maeda Junpei, Akashi Arifumi, Inoue Keiji, Kohara Norihiro, Miyata Akimi, Kanematsu Takashi
Department of Surgery, Nagasaki Municipal Hospital, Nagasaki, Japan.
Case Rep Gastroenterol. 2008 Aug 15;2(2):272-8. doi: 10.1159/000141514.
An eighty-year-old female was transferred to the hospital after experiencing abdominal pain and nausea. She had had a history of total gastrectomy for gastric cancer 14 years previously. Abdominal X-ray revealed a localized expansion of the small bowel. Computed tomography revealed a mass with a lamellar structure in a concentric circle. With a tentative diagnosis of small bowel obstruction due to intussusception, she underwent emergency operation. Laparotomy revealed a retrograde jejuno-jejunal intussusception. Bowel resection was performed due to the severe ischemic damage. All reported intussusception cases after total gastrectomy displayed retrograde characteristics and could occur both during the early and late period after surgery. It is important to consider the possibility of intussusception for patients presenting with acute abdomen who have previously undergone gastric resection.
一名80岁女性在出现腹痛和恶心后被送往医院。她14年前因胃癌接受了全胃切除术。腹部X线检查显示小肠局限性扩张。计算机断层扫描显示一个呈同心圆状分层结构的肿块。初步诊断为肠套叠导致的小肠梗阻,她接受了急诊手术。剖腹探查发现逆行性空肠-空肠套叠。由于严重的缺血性损伤,进行了肠切除术。所有报道的全胃切除术后肠套叠病例均表现出逆行特征,且可发生在术后早期和晚期。对于既往接受过胃切除术且出现急腹症的患者,考虑肠套叠的可能性很重要。