Stamopoulos Paraskevas, Viebahn Richard, Schenker Peter
Department of General, Visceral, and Transplant Surgery, University Hospital Knappschaftskrankenhaus Bochum, Ruhr-University Bochum, Bochum, Germany.
Am J Case Rep. 2018 Jul 6;19:796-799. doi: 10.12659/AJCR.909003.
BACKGROUND Short bowel syndrome (SBS) is a malabsorption syndrome that results from an extensive intestinal resection or repeated small bowel resections. Postoperative small bowel obstruction is a well-known complication of abdominal surgeries requiring readmission and reoperation after failed conservative management. A combination of the above factors poses a clinical challenge for surgeons due to lack of applicable treatment options. CASE REPORT A 68-year-old man underwent repetitive laparotomies and multiple small bowel resections for an incarcerated inguinal hernia, resulting in SBS. Postoperative small bowel obstruction resulting from an anastomotic stricture near the ligament of Treitz made the patient unable to sustain oral nutrition. During reoperation, insufficient jejunum length and extensive intraabdominal adhesions led us to perform a primary side-to-side duodenocolonic anastomosis, which is an unusual treatment option. After a long but uncomplicated postoperative course, the patient was able to ingest solid foods and was discharged in healthy condition with parental nutritional support. CONCLUSIONS Duodenocolostomy can be a treatment of last resort in patients with limited surgical treatment options and can lead to a significant improvement of their quality of life.
背景 短肠综合征（SBS）是一种吸收不良综合征，由广泛的肠切除或反复的小肠切除引起。术后小肠梗阻是腹部手术的一种常见并发症，在保守治疗失败后需要再次入院和再次手术。由于缺乏适用的治疗选择，上述因素的组合给外科医生带来了临床挑战。病例报告 一名68岁男性因嵌顿性腹股沟疝接受了多次剖腹手术和多次小肠切除，导致短肠综合征。Treitz韧带附近吻合口狭窄引起的术后小肠梗阻使患者无法维持口服营养。再次手术时，空肠长度不足和广泛的腹腔内粘连导致我们进行了一次原发性端侧十二指肠结肠吻合术，这是一种不寻常的治疗选择。经过漫长但无并发症的术后过程，患者能够摄入固体食物，并在肠内营养支持下健康出院。结论 十二指肠结肠吻合术可以作为手术治疗选择有限的患者的最后手段，并且可以显著改善他们的生活质量。
