Krishna Sunil, Prabhu Raghunath, Thangavelu Siddharth, Shenoy Rajgopal
Kasturba Medical College, Manipal, Karnataka, India.
BMJ Case Rep. 2013 Jun 27;2013:bcr2013200219. doi: 10.1136/bcr-2013-200219.
The jejuno-jejunal intussusception is a rare complication of jejunostomy tube placement. We are reporting a case of 33-year-old man who was suffering from absolute dysphagia due to carcinoma of cricopharynx with advanced metastatic disease, who underwent Stamms feeding jejunostomy as a part of palliative care. After 1 month he presented with colicky type of pain in the abdomen and vomiting. Sonogram of abdomen revealed a target sign and a feeding tube in a dilated jejunum. Abdominal CT proved the sonographic impression of jejuno-jejunal intussusception. He, therefore, underwent exploratory laparotomy and resection and anastomosis of the intussuscepted bowel. New feeding jejunostomy (FJ) was done distally from the anastomotic site. As per the literature this complication has been reported in Witzels jejunostomy. In our case the patient had undergone Stamms jejunostomy with placement of a Ryle's tube. Intussusception should be considered if a patient comes with abdominal pain and vomiting following FJ.
空肠-空肠套叠是空肠造口管置入术的一种罕见并发症。我们报告一例33岁男性患者,因环咽癌伴晚期转移性疾病导致完全性吞咽困难,作为姑息治疗的一部分接受了 Stamm 氏空肠造口术。1个月后,他出现腹部绞痛和呕吐。腹部超声显示一个靶征以及扩张空肠内的一根饲管。腹部CT证实了空肠-空肠套叠的超声表现。因此,他接受了剖腹探查术以及套叠肠段的切除和吻合术。在吻合口远端进行了新的空肠造口术(FJ)。根据文献,这种并发症在维泽尔氏空肠造口术中已有报道。在我们的病例中,患者接受的是带有莱氏管置入的Stamm氏空肠造口术。如果患者在空肠造口术后出现腹痛和呕吐,应考虑套叠的可能。