Burke Eoghan, Connelly Tara, Mehmood Abeera, Murphy Maurice, O'Donoghue Gerrard
Department of Surgery, University Hospital Waterford, Waterford, Ireland.
Department of Pathology, University Hospital Waterford, Waterford, Ireland.
J Surg Case Rep. 2018 Mar 26;2018(3):rjy039. doi: 10.1093/jscr/rjy039. eCollection 2018 Mar.
We report a case of a 79-year-old gentleman who presented to the emergency department with a 5-day history of abdominal pain, constipation, a progressively distending abdomen and new onset feculent vomiting on a background of a recent endoscopic decompression of a sigmoid volvulus. Investigations confirmed the presence of a recurrent sigmoid volvulus. Attempts to reduce this endoscopically failed and laparotomy with sub-total colectomy and ileostomy formation was performed. Histology from the resected specimen identified a distinct pathology, namely intestinal lipofuscinosis also known as brown bowel syndrome. Brown bowel syndrome is a recognized but rare complication of chronic long term malnutrition. It may present in a myriad of ways including atonia and, rarely, massive colonic dilatation, as in our case.
我们报告一例79岁男性患者，其因腹痛、便秘、腹部进行性膨隆及新近出现的粪样呕吐5天而就诊于急诊科，其背景是近期对乙状结肠扭转进行了内镜减压。检查证实存在复发性乙状结肠扭转。内镜下复位该扭转的尝试失败，遂行剖腹手术，进行了次全结肠切除术并造了回肠造口。切除标本的组织学检查发现了一种独特的病理情况，即肠道脂褐质沉积症，也称为棕色肠综合征。棕色肠综合征是一种公认但罕见的慢性长期营养不良并发症。它可能以多种方式出现，包括肠无力，以及在我们这个病例中罕见的大量结肠扩张。
