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罕见肠梗阻病因的开放手术治疗:左侧十二指肠旁疝

Open Surgery Treatment of a Rare Cause of Intestinal Obstruction: Left Paradoudenal Hernia.

作者信息

Trieu Trieu Duong, Van Le Quoc, Van Nguyen Hien

机构信息

Department of Colon and Rectal Surgery, The 108 Military Central Hospital, Hanoi, Vietnam.

出版信息

Int Med Case Rep J. 2021 Jan 25;14:11-14. doi: 10.2147/IMCRJ.S295622. eCollection 2021.

Abstract

An internal hernia is the protrusion of visceral contents through a congenital or acquired defect in the peritoneum or mesentery within the abdominal cavity. In approximately 0.6-5.8% of patients with small intestinal obstruction, the cause is internal hernia, with paraduodenal hernias accounting for approximately 40% of cases. Here, we present the case of a 51-year-old man diagnosed with obstruction of the small intestine caused by a hernia on the left side of the duodenum. The treatment involved returning the bowel loops to the normal position and closing the hernia pocket using Prolene 2.0 sutures. The duration of the surgery was 30 min. Five days later, the patient's condition was stable and he was discharged from the hospital; at the 32-month postoperative follow-up, he remained in stable condition with no recurrence. An abdominal computed tomography scan is valuable for early diagnosis of paraduodenal hernia in the absence of complications, and the cause can be identified and the bowel returned to the normal position by endoscopic surgery, with closure of the hernia pocket if the intestine does not stick to the pocket.

摘要

内疝是指腹腔内的内脏内容物通过腹膜或肠系膜的先天性或后天性缺损突出。在大约0.6%-5.8%的小肠梗阻患者中,病因是内疝,其中十二指肠旁疝约占病例的40%。在此,我们报告一例51岁男性患者,诊断为十二指肠左侧疝导致小肠梗阻。治疗方法是将肠袢恢复到正常位置,并用2.0号普理灵缝线关闭疝囊。手术持续时间为30分钟。五天后,患者病情稳定出院;术后32个月随访时,他仍处于稳定状态,无复发。腹部计算机断层扫描对于在无并发症情况下早期诊断十二指肠旁疝很有价值,并且可以通过内镜手术确定病因并将肠管恢复到正常位置,如果肠管未与疝囊粘连则关闭疝囊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b8/7846872/8824d68e7cfe/IMCRJ-14-11-g0001.jpg

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