Bing-Lu Li, Xin Huang, Chao-Ji Zheng, Jiao-Lin Zhou, Yu-Pei Zhao, The First Department of General Surgery, Peking Union Medical College Hospital, Beijing 100730, China.
World J Gastroenterol. 2013 Oct 14;19(38):6500-4. doi: 10.3748/wjg.v19.i38.6500.
Intestinal duplication is an uncommon congenital condition in young adults. A 25-year-old man complained of chronic, intermittent abdominal pain for 3 years following previous appendectomy for the treatment of suspected appendicitis. Abdominal discomfort and pain, suggestive of intestinal obstruction, recurred after operation. A tubular mass was palpable in the right lower quadrant. Computed tomography enterography scan identified suspicious intestinal intussusception, while Tc-99m pertechnetate scintigraphy revealed a cluster of strip-like abnormal radioactivity in the right lower quadrant. On exploratory laparotomy, a tubular-shaped ileal duplication cyst was found arising from the mesenteric margin of the native ileal segment located 15 cm proximal to the ileocecal valve. Ileectomy was performed along with the removal of the duplication disease, and the end-to-end anastomosis was done to restore the gastrointestinal tract continuity. Pathological examination showed ileal duplication with ectopic gastric mucosa. The patient experienced an eventless postoperative recovery and remained asymptomatic within 2 years of postoperative follow-up.
肠重复畸形是一种罕见的青年成人先天性疾病。一名 25 岁男性,曾因疑似阑尾炎行阑尾切除术,术后 3 年出现慢性间歇性腹痛。术后出现腹部不适和疼痛,提示肠梗阻。右下象限可触及管状肿块。CT 肠造影扫描提示可疑肠套叠,而 Tc-99m 过锝酸盐闪烁扫描显示右下象限呈簇状条状异常放射性。剖腹探查发现,从距回盲瓣近端 15cm 的回肠段肠系膜边缘处出现管状回肠重复囊肿。行回肠部分切除术和重复病变切除术,行端端吻合术恢复胃肠道连续性。病理检查显示回肠重复伴异位胃黏膜。患者术后恢复顺利,无并发症,术后 2 年随访无症状。