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游走肝与肠旋转不良:首例报告

Wandering liver and intestinal malrotation: first report.

作者信息

Ordonez Alex, Nguyen David, Mlacker Stephanie, Ordonez Andrea, Lo Menzo Emanuele, Szomstein Samuel, Rosenthal Raul

机构信息

The Bariatric and Metabolic Institute, Section of Minimally Invasive Surgery, Department of General and Vascular Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL, 33331, USA.

Department of General Surgery Residency Program and Fellowship in Minimally Invasive and Bariatric Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.

出版信息

Surg Case Rep. 2016 Dec;2(1):80. doi: 10.1186/s40792-016-0205-y. Epub 2016 Aug 6.

Abstract

A wandering liver is a rare development in both the adult and pediatric population where the liver is freely displaced along a transverse axis. We describe the first known occurrence in published literature of a wandering liver in an adult individual who also had an intestinal malrotation complicated by a midgut volvulus. The abnormal ability for a liver to wander presents a highly unusual anatomy that can be disorienting. Laparoscopic surgery is a viable option in reducing a midgut volvulus and addressing an intestinal malrotation in the presence of a wandering liver. This unusual presentation educates clinicians to avoid potential misdiagnosis given the abnormal location of the duodenum, appendix, liver, and gallbladder.

摘要

游走肝在成人和儿童群体中均属罕见发育情况,即肝脏沿横轴自由移位。我们描述了首例在已发表文献中出现的成人游走肝病例,该患者同时伴有肠旋转不良并并发中肠扭转。肝脏异常的游走能力呈现出一种极为特殊的解剖结构,可能会使人产生定向障碍。在存在游走肝的情况下,腹腔镜手术是减少中肠扭转和处理肠旋转不良的可行选择。鉴于十二指肠、阑尾、肝脏和胆囊位置异常,这种特殊表现提醒临床医生避免潜在的误诊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46c2/4975732/cac0060c21f3/40792_2016_205_Fig1_HTML.jpg

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