Choy Kay Tai, Brunott Nathan
Cairns Hospital, Cairns North, Queensland, Australia.
BMJ Case Rep. 2019 Jun 26;12(6):e229157. doi: 10.1136/bcr-2018-229157.
Small bowel volvulus (SBV) is often challenging to diagnose. Research suggests that the clinical presentation of this disease is often very similar to other more common causes of small bowel obstruction (SBO) such as intraabdominal adhesions and no single preoperative diagnostic study is sensitive or specific enough to identify this rare cause of mechanical SBO. This report describes a case of a 19-year-old woman who presented with irretractable vomiting and abdominal pain secondary to SBV. This case is unusual as her history of recurrent adhesive SBO presented a diagnostic dilemma that required a higher degree of clinical suspicion to tease these differential diagnoses apart. She underwent laparoscopy which facilitated successful detorsion and resection of the floppy tongue of jejunum. This report aims to increase the awareness among surgeons.
小肠扭转(SBV)的诊断往往具有挑战性。研究表明,这种疾病的临床表现通常与其他更常见的小肠梗阻(SBO)原因非常相似,如腹腔内粘连,而且没有单一的术前诊断研究对识别这种罕见的机械性SBO原因具有足够的敏感性或特异性。本报告描述了一例19岁女性患者,因SBV出现顽固性呕吐和腹痛。该病例不同寻常之处在于,她复发性粘连性SBO的病史带来了诊断难题,需要更高程度的临床怀疑来区分这些鉴别诊断。她接受了腹腔镜检查,该检查有助于成功扭转并切除松弛的空肠襻。本报告旨在提高外科医生的认识。