Grandić Leo, Pogorelić Zenon, Prusac Ivana Kuzmić, Perko Zdravko, Boschi Vladimir, Punda Ante, Mrklić Ivana
University of Split, Split University Hospital Center, Department of Surgery, Split, Croatia.
Coll Antropol. 2012 Dec;36(4):1457-60.
Non-specific ulcerations of the small intestine are very rare. The cause and pathogenesis of these lesions remain obscure. The diagnosis of primary ileal ulcer is commonly overlooked and infrequently is established intraoperatively. Here we described a case of a 73-year-old woman who was presented to the emergency surgical department with the five days history of vomiting, distension, constipation, and abdominal pain. On physical examination abdomen was mildly distended and diffusely painful on palpation. Bowel sounds were present and active. Plain abdominal x-ray film showed ileus of the small intestine. Multislice computed tomography showed stenosing process of the ileum. Patient underwent exploratory laparotomy. Approximately 60 cm from the ileocecal valve ileum was inflamed and hypertrophic with a point of obstruction. Grossly, it appeared as a small intestine carcinoma. Involved segment of ileum including the point of obstruction was resected. Pathological examination showed ulceration of the ileum. After the surgery the patient made rapid recovery and was discharged from the hospital on the tenth postoperative day.
小肠的非特异性溃疡非常罕见。这些病变的病因和发病机制仍不清楚。原发性回肠溃疡的诊断通常被忽视，术中很少能确诊。在此我们描述了一例73岁女性患者，她因呕吐、腹胀、便秘和腹痛5天而被送往急诊外科。体格检查时，腹部轻度膨胀，触诊时有弥漫性疼痛。肠鸣音存在且活跃。腹部平片显示小肠梗阻。多层计算机断层扫描显示回肠有狭窄病变。患者接受了剖腹探查术。距回盲瓣约60厘米处的回肠发炎、肥厚并有一个梗阻点。大体上，它看起来像小肠癌。包括梗阻点在内的受累回肠段被切除。病理检查显示回肠溃疡。手术后患者恢复迅速，术后第10天出院。
