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胃手术后发生空肠胃套叠的罕见病例。

A rare case of jejunogastric intussusception following gastric surgery.

作者信息

Vaidya Yash, Vaithianathan Rajan

机构信息

Dept. of General Surgery, Mahatma Gandhi Medical College, Sri Balaji Vidyapeeth University, Pondicherry, India.

出版信息

Int J Surg Case Rep. 2017;31:103-105. doi: 10.1016/j.ijscr.2017.01.014. Epub 2017 Jan 10.

Abstract

INTRODUCTION

Jejunogastric intussusception (JGI) is an extremely rare complication of prior gastric surgery. Fewer than 200 cases have been reported in the literature.

CASE PRESENTATION

We present a case of an elderly male who presented with typical abdominal pain, hematemesis and a palpable epigastric mass. Ultrasonography and upper endoscopy diagnosed jejunogastric intussusception. Emergent laparotomy with manual reduction of the efferent loop intussusception resulted in successful treatment.

DISCUSSION

We report this case of efferent loop JGI, developing 40 years after the primary Billroth II gastrectomy. This is the longest interval from the initial gastric surgery for gastric cancer to be reported.

CONCLUSION

Maintaining a high index of suspicion is paramount in early diagnosis and treatment of this condition, which is associated with high mortality rates if surgery is delayed.

摘要

引言

空肠胃套叠(JGI)是既往胃手术极为罕见的并发症。文献报道的病例不足200例。

病例介绍

我们报告一例老年男性患者,表现为典型的腹痛、呕血和上腹部可触及肿块。超声检查和上消化道内镜检查诊断为空肠胃套叠。急诊剖腹手术,手动复位输出袢肠套叠,治疗成功。

讨论

我们报告了这例输出袢空肠胃套叠病例,发生在初次毕Ⅱ式胃切除术后40年。这是报道的从最初胃癌胃手术到发生该并发症间隔时间最长的病例。

结论

对此病症进行早期诊断和治疗时,保持高度怀疑指数至关重要,若手术延迟,死亡率会很高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff49/5266484/4c2ecd1d7946/gr1.jpg

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