Sakaguchi Tatsuma, Tokuhara Katsuji, Nakatani Kazuyoshi, Kon Masanori
Department of Surgery, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka, 570-8507, Japan.
Int J Surg Case Rep. 2017;39:309-312. doi: 10.1016/j.ijscr.2017.08.048. Epub 2017 Sep 1.
Nonspecific small bowel ulcers are rare and there have been limited reports. We applied laparoscopic surgery successfully for the perforation caused by this disease of jejunum.
A 70-year-old man visited to our hospital with complaint of abdominal pain and fever. He was diagnosed abdominal peritonitis with findings of intraperitoneal gas and fluid. Emergency laparoscopic surgery was performed. A perforation 5mm in diameter was recognized in jejunum opposite side of mesentery. Partial resection of jejunum with end-to-end anastomosis and peritoneal lavage were performed. Pathologically, an ulcer was recognized around the blowout perforation without specific inflammation. He was discharged uneventfully 12days after surgery.
Laparoscopic surgery has diagnostic and therapeutic advantages because of its lower invasion with a good operation view, and in case of the small bowel, it is easy to shift extra-corporeal maneuver.
非特异性小肠溃疡较为罕见，相关报道有限。我们成功应用腹腔镜手术治疗了由空肠该疾病引起的穿孔。
一名70岁男性因腹痛和发热前来我院就诊。经检查发现腹腔内有气体和液体，诊断为急性腹膜炎。遂进行了急诊腹腔镜手术。在肠系膜对侧的空肠处发现一个直径5毫米的穿孔。实施了空肠部分切除端端吻合术及腹腔灌洗。病理检查显示，在穿孔周围可见溃疡，无特异性炎症。术后12天患者顺利出院。
腹腔镜手术具有诊断和治疗优势，因其侵袭性较低且手术视野良好，对于小肠手术而言，便于进行体外操作。
