彼得森疝所致肠扭转引起肠梗阻伴乳糜性腹水：病例报告
Chylous ascites associated with intestinal obstruction from volvulus due to Petersen's hernia: report of a case.
作者信息
Akama Yuichi, Shimizu Tetsuya, Fujita Itsuo, Kanazawa Yoshikazu, Kakinuma Daisuke, Kanno Hitoshi, Yamagishi Aya, Arai Hiroki, Uchida Eiji
机构信息
Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, Japan.
出版信息
Surg Case Rep. 2016 Dec;2(1):77. doi: 10.1186/s40792-016-0207-9. Epub 2016 Jul 28.
BACKGROUND
Chylous ascites is an uncommon finding which is usually associated with recent abdominal/oncologic or retroperitoneal surgery. It is not usually seen in cases of acute obstruction.
CASE PRESENTATION
A patient who had previously undergone a laparoscopy-assisted distal gastrectomy with Roux-en-Y reconstruction for early gastric cancer presented with acute abdominal pain and epigastric fullness. Computed tomography suggested small bowel obstruction due to volvulus. We were able to reduce the volvulus and close a Petersen's hernia without resecting the bowel; a large amount of chylous ascites was an incidental finding.
CONCLUSIONS
We present a case of chylous ascites occurring in a setting of small bowel obstruction due to Petersen's hernia, 3 years after successful distal gastrectomy for early gastric cancer, with no evidence of tumor recurrence.
背景
乳糜性腹水是一种罕见的情况，通常与近期的腹部/肿瘤或腹膜后手术有关。在急性梗阻病例中通常不会出现。
病例介绍
一名曾因早期胃癌接受腹腔镜辅助远端胃切除术并进行 Roux-en-Y 重建的患者出现急性腹痛和上腹部饱胀感。计算机断层扫描提示因肠扭转导致小肠梗阻。我们成功复位了肠扭转并闭合了彼得森疝，未进行肠切除；大量乳糜性腹水是偶然发现的。
结论
我们报告一例在早期胃癌成功进行远端胃切除术后 3 年，因彼得森疝导致小肠梗阻并出现乳糜性腹水的病例，且无肿瘤复发证据。
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