Taniguchi Kohei, Iida Ryo, Watanabe Tomohiko, Nitta Masahiko, Tomioka Masao, Uchiyama Kazuhisa, Takasu Akira
Department of Emergency Medicine, Osaka Medical College, Takatsuki, Japan ; Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Japan.
Department of Emergency Medicine, Osaka Medical College, Takatsuki, Japan.
Nagoya J Med Sci. 2017 Feb;79(1):109-113. doi: 10.18999/nagjms.79.1.109.
Strangulated intestinal obstruction is one of the most common types of acute abdomen and requires urgent surgical treatment. Herein, we report a very rare case of strangulated intestinal obstruction caused by an ileo-ileal knot. An 80-year-old woman was admitted to our hospital with suspicion of strangulation ileus and underwent emergency laparotomy after investigation by exploratory single-port laparoscopy. During surgery, a small bowel gangrene caused by an ileo-ileal knot was found. The gangrenous segment was resected, and primary anastomosis was performed. Post-operative recovery was uneventful except for a minor wound infection. Our extensive search of the literature found only 7 case reports of ileo-ileal knot including ours. An ileo-ileal knot should be considered in the differential diagnosis of acute intestinal obstruction, because this rare phenomenon requires urgent surgical treatment; and some complications should be considered during or after surgery.
绞窄性肠梗阻是急腹症最常见的类型之一,需要紧急手术治疗。在此,我们报告一例极为罕见的由回肠-回肠纽结引起的绞窄性肠梗阻病例。一名80岁女性因疑似绞窄性肠梗阻入住我院,经单孔腹腔镜探查后行急诊剖腹手术。术中发现由回肠-回肠纽结导致的小肠坏疽。切除坏疽肠段并进行一期吻合。术后除有轻微伤口感染外,恢复顺利。我们广泛查阅文献,发现包括我们这例在内仅有7例回肠-回肠纽结的病例报告。在急性肠梗阻的鉴别诊断中应考虑回肠-回肠纽结,因为这种罕见情况需要紧急手术治疗;并且在手术期间或术后应考虑一些并发症。