Stewart B A, Karrer F M, Hall R J, Lilly J R
Department of Surgery, University of Colorado School of Medicine, Denver.
J Pediatr Surg. 1990 Aug;25(8):905-8. doi: 10.1016/0022-3468(90)90201-j.
Anatomical abnormalities of the small bowel that cause intestinal stagnation result in bacterial overgrowth and a blind loop syndrome (BLS). Bacterial breakdown of bile salts and deamination of protein lead to malabsorption, steatorrhea, and fat-soluble vitamin deficiencies. Four children developed BLS as a complication of necrotizing enterocolitis, jejunal atresia, gastroschisis, and biliary atresia. BLS was suggested by abdominal pain, feculent vomiting, steatorrhea, and hypoalbuminemia. Dilated, stagnant bowel loops were demonstrated in each instance by upper gastrointestinal contrast study. Positive intestinal bacterial aspirates were confirmatory. Antibiotic treatment in two patients improved symptomatology but all children ultimately required surgery. Surgical procedures consisted of blind loop resection, intestinal plication, and catheterization of the bilioenteric conduit. All patients are now asymptomatic but one child suffers from parenteral nutrition-related cirrhosis and another requires chronic antibiotic therapy.
导致肠道淤滞的小肠解剖异常会引起细菌过度生长及盲袢综合征（BLS）。胆盐的细菌分解和蛋白质的脱氨基作用会导致吸收不良、脂肪泻和脂溶性维生素缺乏。4名儿童因坏死性小肠结肠炎、空肠闭锁、腹裂和胆道闭锁并发症而发生BLS。腹痛、粪样呕吐、脂肪泻和低白蛋白血症提示BLS。上消化道造影检查在每个病例中均显示有扩张、淤滞的肠袢。阳性的肠道细菌抽吸物可确诊。2例患者接受抗生素治疗后症状改善，但所有儿童最终均需要手术。手术方式包括盲袢切除术、肠折叠术和胆肠吻合管插管术。所有患者目前均无症状，但1名儿童患有肠外营养相关肝硬化，另1名儿童需要长期抗生素治疗。
