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自杀性吞服酸导致胃出口梗阻并经早期确定性手术治疗——病例报告

Suicidal acid ingestion leading to gastric outlet obstruction treated by early definitive surgery-case report.

作者信息

Almalki Mutlaq, Yaseen Waed, Althobaiti Shatha

机构信息

Alnoor Specialist Hospital, General Surgery Department, Makkah, Saudi Arabia.

出版信息

J Surg Case Rep. 2021 Feb 19;2021(2):rjab027. doi: 10.1093/jscr/rjab027. eCollection 2021 Feb.

Abstract

Chemical ingestions can cause acute injury to the oesophagus, stomach, pylorus, duodenum and sometimes other organs after ingestion of corrosives, but it may be as late as 1 year after ingestion. A 30-year-old male patient presented to the emergency department with sudden epigastric abdominal pain after flash material ingestion. Computed tomography of abdomen showed signs of small bowel obstruction associated with segmental small bowel ischaemic changes. Postoperatively, patient developed an intolerance to oral intake with upper gastrointestinal scope showing sever stricture at the distal gastric lumen and pylorus. The patient was taken to the operation where gastrojejunostomy and brown procedure was done. Corrosive gastric injury treatment depends on the degree of gastric involvement, related oesophageal strictures and the patient's general health. Early surgery offers very satisfactory and physiological results, whereas avoiding gastric resection or bypass provides very satisfactory and physiological outcomes.

摘要

化学物质摄入后,腐蚀性物质进入人体可导致食管、胃、幽门、十二指肠以及有时其他器官的急性损伤,但这种损伤可能在摄入后长达1年才出现。一名30岁男性患者在摄入闪光材料后因突发上腹部疼痛就诊于急诊科。腹部计算机断层扫描显示小肠梗阻迹象并伴有节段性小肠缺血改变。术后,患者出现口服不耐受,上消化道内镜检查显示胃远端腔和幽门严重狭窄。患者接受了手术,进行了胃空肠吻合术和布朗手术。腐蚀性胃损伤的治疗取决于胃受累程度、相关食管狭窄以及患者的总体健康状况。早期手术可提供非常满意的生理结果,而避免胃切除或旁路手术也能带来非常满意的生理结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a32c/7896840/e59b83a90ba9/rjab027f1.jpg

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