Butterworth J, Cross Trent, Butterworth William, Mousa Paul, Thomas S
Cairns Base Hospital, Cairns, Queensland, 4870, Australia.
Int J Surg Case Rep. 2013;4(7):568-70. doi: 10.1016/j.ijscr.2013.01.032. Epub 2013 Apr 2.
Transmesenteric herniae are a rare cause of bowel ischaemia in adults with few reported cases in published literature.
We report a rare case of a 26-year-old female with spontaneous transmesenteric hernia of jejunum and proximal ileum due to a congenital mesenteric defect resulting in bowel gangrene, presenting initially with no haemodynamic or biochemical abnormalities. The hernia was reduced, small bowel resected and primary side to side anastomosis performed, following which the patient made a good recovery and was discharged 5 days later.
The insidious onset of transmesenteric herniae and lack of specific radiological or laboratory investigations reaffirms the importance of surgeons maintaining a high index of suspicion for this critical surgical emergency.
Close monitoring of the patient's general condition in cases of non-specific abdominal pain is essential to identify the rare deteriorating patient for early surgical intervention and optimal outcome.
经肠系膜疝是成人肠道缺血的罕见原因,已发表的文献中报道的病例很少。
我们报告了一例罕见的26岁女性病例,该患者因先天性肠系膜缺损导致空肠和回肠近端自发性经肠系膜疝,进而引起肠坏疽,最初表现为无血流动力学或生化异常。对疝进行了还纳,切除了小肠并进行了端端吻合术,术后患者恢复良好,5天后出院。
经肠系膜疝的隐匿起病以及缺乏特异性的影像学或实验室检查再次强调了外科医生对此类严重外科急症保持高度怀疑的重要性。
对于非特异性腹痛患者,密切监测其一般状况对于识别罕见的病情恶化患者以进行早期手术干预并获得最佳结果至关重要。