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RYGB 术后引起的肠道动力障碍和逆行肠套叠:一种不常见的现象。一项叙事性文献回顾。

RYGB-Induced Gut Dysmotility and Retrograde Intussusception: an Unusual Phenomenon. A Narrative Literature Review.

机构信息

Division of Gastrointestinal Surgery, Department of Surgery, University of South Florida, Morsani College of Medicine, 5 Tampa General Circle, Tampa, FL, 33606, USA.

Department of Surgery, Houston Methodist, 6550 Fannin St., Houston, TX, 77030, USA.

出版信息

Obes Surg. 2022 Oct;32(10):3452-3457. doi: 10.1007/s11695-022-06236-0. Epub 2022 Aug 10.

Abstract

Intussusception following Roux-en-Y gastric bypass (RYGB) is a rare complication of bariatric surgery with an unclear etiology. The pathogenesis underlying intussusception after gastric bypass is likely different from that in the general population. Post-RYGB intussusception might be related to motility issues in the divided small bowel, thinning of the mesentery following rapid weight loss, or anastomotic sutures/staple line acting as the lead point. This condition can cause obstruction with subsequent strangulation and bowel necrosis if not recognized and treated promptly. Clinical presentation is vague and nonspecific, and computerized tomography scan represents the diagnostic test of choice. Surgical treatment consists of reduction with or without anastomosis resection and reconstruction. This literature review provides an extensive overview of this condition, based on multiple studies involving 120 patients.

摘要

胃旁路术后(RYGB)肠套叠是一种罕见的减重手术并发症,其病因尚不清楚。胃旁路术后肠套叠的发病机制可能与普通人群不同。RYGB 后肠套叠可能与分割小肠的运动问题、快速减肥后肠系膜变薄或吻合口缝线/吻合钉作为引导点有关。如果不及时发现和治疗,这种情况可能会导致梗阻,随后发生绞窄和肠坏死。临床表现模糊且非特异性,计算机断层扫描是首选的诊断检查。手术治疗包括复位,必要时行吻合口切除和重建。基于涉及 120 名患者的多项研究,本文对该疾病进行了广泛的综述。

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