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关于“无肠道综合征”的更多内容:一则病例报告。

More on 'No Gut Syndrome': A case report.

作者信息

Jain Varun, Huerta Sergio

机构信息

Maulana Azad Medical College and Lok Nayak Hospital, University of Delhi, Delhi 110002, India.

University of Texas Southwestern Medical Center, VA North Texas Health Care System, 4500 S. Lancaster Road, Dallas, TX 75216, United States.

出版信息

Int J Surg Case Rep. 2016;19:35-7. doi: 10.1016/j.ijscr.2015.12.014. Epub 2015 Dec 17.

Abstract

INTRODUCTION

No Gut Syndrome refers to a condition which results after a near total enterectomy (NTE) has been performed. These patients are unable to sustain life without life-long parenteral nutrition (PN). Re-establishment of bowel continuity, complications, quality of life (QoL), and overall outcomes are important aspects to be considered in patients who might need a NTE. We have previously reported two similar cases as well as a literature review in patients with No Gut Syndrome. In the present report, we present an additional case and an update of the literature.

PRESENTATION OF THE CASE

A 62-year old man with multiple co-morbidities presented with features of acute small bowel obstruction. Exploratory laparotomy revealed severe mesenteric ischemia and extensive small bowel necrosis. Patient eventually underwent a NTE and was discharged on parenteral nutrition.

DISCUSSION

Near total enterectomy (NTE) is a clinical condition in which a patient is left without or with minimal length of small bowel along with either gastrointestinal continuity or exteriorization of the proximal end. This condition has remained a dilemma for surgeons worldwide chiefly as a result of its perceived incompatibility with life. There are only a few available options for proceeding with treatment, however maintenance on long term parenteral nutrition has shown promising results.

CONCLUSION

Long term parenteral nutrition serves as a viable treatment option for managing patients after a NTE.

摘要

引言

无肠综合征是指在实施近乎全小肠切除术(NTE)后出现的一种病症。这些患者若无终身肠外营养(PN)则无法维持生命。对于可能需要进行NTE的患者,恢复肠道连续性、并发症、生活质量(QoL)以及总体预后是需要考虑的重要方面。我们之前曾报道过两例类似病例以及一篇关于无肠综合征患者的文献综述。在本报告中,我们呈现了另外一例病例及文献更新情况。

病例介绍

一名患有多种合并症的62岁男性因急性小肠梗阻症状就诊。剖腹探查显示严重的肠系膜缺血和广泛的小肠坏死。患者最终接受了NTE,并在肠外营养支持下出院。

讨论

近乎全小肠切除术(NTE)是一种临床状况,即患者术后剩余极少长度的小肠或完全没有小肠,同时伴有胃肠道连续性或近端小肠外置。这种情况一直是全球外科医生面临的难题,主要是因为其被认为与生命不相容。目前可供选择的治疗方案很少,然而长期肠外营养维持已显示出有希望的结果。

结论

长期肠外营养是管理NTE术后患者的一种可行治疗选择。

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