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伴有空肠憩室的小肠扭转:原发性还是继发性?

Small bowel volvulus with jejunal diverticulum: Primary or secondary?

作者信息

Shen Xiao-Fei, Guan Wen-Xian, Cao Ke, Wang Hao, Du Jun-Feng

机构信息

Xiao-Fei Shen, Wen-Xian Guan, Ke Cao, Hao Wang, Department of General Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China.

出版信息

World J Gastroenterol. 2015 Sep 28;21(36):10480-4. doi: 10.3748/wjg.v21.i36.10480.

Abstract

Small bowel volvulus, which is torsion of the small bowel and its mesentery, is a medical emergency, and is categorized as primary or secondary type. Primary type often occurs without any apparent intrinsic anatomical anomalies, while the secondary type is common clinically and could be caused by numerous factors including postoperative adhesions, intestinal diverticulum, and/or tumors. Here, we report a rare case of a 60-year-old man diagnosed with small bowel volvulus using multidetector computed tomography (MDCT) angiography. Further discovery by laparotomy showed one jejunal diverticulum, longer corresponding mesentery with a narrower insertion, and a lack of mesenteric fat. This case report includes several etiological factors of small bowel volvulus, and we discuss the possible cause of small bowel volvulus in this patient. We also highlight the importance of MDCT angiography in the diagnosis of volvulus and share our experience in treating this disease.

摘要

小肠扭转是指小肠及其系膜发生扭转,是一种医疗急症,分为原发性或继发性。原发性小肠扭转通常在没有任何明显内在解剖异常的情况下发生,而继发性小肠扭转在临床上较为常见,可能由多种因素引起,包括术后粘连、肠憩室和/或肿瘤。在此,我们报告一例罕见病例,一名60岁男性通过多排螺旋计算机断层扫描(MDCT)血管造影被诊断为小肠扭转。剖腹手术进一步发现一个空肠憩室,相应系膜较长且插入处较窄,并且缺乏肠系膜脂肪。本病例报告包含小肠扭转的多种病因,我们讨论了该患者小肠扭转的可能原因。我们还强调了MDCT血管造影在扭转诊断中的重要性,并分享了我们治疗这种疾病的经验。

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本文引用的文献

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Whirl sign in small bowel volvulus.小肠扭转的漩涡征。
BMJ Case Rep. 2012 Aug 13;2012:bcr2012006688. doi: 10.1136/bcr-2012-006688.
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Multiphasic MDCT in small bowel volvulus.多层螺旋 CT 多期扫描在小肠扭转中的应用。
Eur J Radiol. 2010 Nov;76(2):e13-8. doi: 10.1016/j.ejrad.2009.10.026. Epub 2009 Nov 18.
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Jejunal diverticulosis: a potentially dangerous entity.空肠憩室病:一种潜在危险的病症。
Scand J Gastroenterol. 2004 Sep;39(9):905-9. doi: 10.1080/00365520410006288.

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