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[盲肠扭转:1例报告并文献复习]

[Cecal volvulus: one case and literature review].

作者信息

Camacho-Aguilera José Francisco, Calderón-Vieyra Antonio

机构信息

Instituto Mexicano del Seguro Social, Hospital General de Zona No. 3, Servicio de Cirugía General. San Juan del Río, Querétaro, México.

Instituto Mexicano del Seguro Social, Hospital General de Zona.

出版信息

Rev Med Inst Mex Seguro Soc. 2022 Aug 31;60(5):591-598.

PMID:36049083
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10395989/
Abstract

BACKGROUND

Cecal volvulus is a rare disease that causes intestinal obstruction. It has various congenital and acquired risk factors. It is frequently associated with abnormal cecal fixation, and it is caused by torsion of the cecum in one of its three axes. It is not different from other causes of intestinal obstruction, but a delay in its diagnosis can lead to ischemia, necrosis and colon perforation. Its management depends on the viability of the tissues, ranging from untwisting and cecopexy to hemicolectomy with or without anastomosis. We present a case of caecal volvulus (caecal bascule) and review the literature as well.

CLINICAL CASE

43-year-old female, who was admitted to an emergency department with data of intestinal obstruction. A simple tomography of the abdomen was performed, where a dilated colon and an image that resembles an inverted coffee bean were identified. An exploratory laparotomy was performed, identifying a bascule-type cecal volvulus, without vascular compromise. Devolvulation, decompression through appendectomy, and caecopexy were performed. After the surgical event, the patient recovered without incident and was discharged with adequate controls by external consultation.

CONCLUSIONS

Cecal volvulus is a cause of intestinal obstruction with a low incidence, which is why early recognition and treatment are key to avoiding the complications that its evolution entails. This type of disease should be among our differential diagnoses, since treatment is surgical and delay leads to a high mortality rate.

摘要

背景

盲肠扭转是一种导致肠梗阻的罕见疾病。它有多种先天性和后天性危险因素。它常与盲肠固定异常相关,由盲肠在其三个轴之一上扭转引起。它与其他肠梗阻原因并无不同,但诊断延迟可导致缺血、坏死和结肠穿孔。其治疗取决于组织的活力,范围从扭转复位和盲肠固定术到有或无吻合的半结肠切除术。我们报告一例盲肠扭转(盲肠襻式扭转)病例并复习相关文献。

临床病例

一名43岁女性因肠梗阻数据被收入急诊科。进行了简单的腹部断层扫描,发现结肠扩张以及一个类似倒咖啡豆的影像。进行了剖腹探查术,确定为襻式盲肠扭转,无血管受损。进行了扭转复位、通过阑尾切除术减压以及盲肠固定术。手术后,患者顺利康复,经门诊适当检查后出院。

结论

盲肠扭转是肠梗阻的一个低发病率病因,这就是为什么早期识别和治疗是避免其病情发展所带来并发症的关键。这类疾病应在我们的鉴别诊断范围内,因为治疗是手术治疗,延迟治疗会导致高死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c40c/10395989/a6a7bb5a08be/04435117-60-5-591-f003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c40c/10395989/7e6424161cac/04435117-60-5-591-f001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c40c/10395989/515092499ca7/04435117-60-5-591-f002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c40c/10395989/f7d90e795861/04435117-60-5-591-c001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c40c/10395989/a6a7bb5a08be/04435117-60-5-591-f003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c40c/10395989/7e6424161cac/04435117-60-5-591-f001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c40c/10395989/515092499ca7/04435117-60-5-591-f002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c40c/10395989/f7d90e795861/04435117-60-5-591-c001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c40c/10395989/a6a7bb5a08be/04435117-60-5-591-f003.jpg

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本文引用的文献

1
Synchronous volvulus of the cecum and sigmoid colon: a rare cause of intestinal obstruction.盲肠和乙状结肠同时扭转:一种罕见的肠梗阻病因。
Cir Cir. 2021;89(S2):4-8. doi: 10.24875/CIRU.21000044.
2
Cecal volvulus in rural Kenya: delayed presentation contributes to high mortality.肯尼亚农村的盲肠扭转:延迟就诊导致高死亡率。
BMC Surg. 2021 Dec 19;21(1):430. doi: 10.1186/s12893-021-01416-8.
3
Cecal volvulus in an adult male: A rare cause of intestinal obstruction: A case report.成年男性盲肠扭转:肠梗阻的罕见病因:一例报告
Int J Surg Case Rep. 2021 Aug;85:106186. doi: 10.1016/j.ijscr.2021.106186. Epub 2021 Jul 8.
4
Synchronous Volvulus of the Transverse Colon and Cecum Associated with Scleroderma and Lupus.与硬皮病和狼疮相关的横结肠和盲肠同步扭转
Radiol Case Rep. 2020 Nov 28;16(2):273-277. doi: 10.1016/j.radcr.2020.11.020. eCollection 2021 Feb.
5
Caecal volvulus in an incisional hernia.切口疝中的盲肠扭转
J Surg Case Rep. 2020 Oct 31;2020(10):rjaa422. doi: 10.1093/jscr/rjaa422. eCollection 2020 Oct.
6
Acute Volvulus of the Cecum.盲肠急性扭转
J Belg Soc Radiol. 2020 Jul 3;104(1):40. doi: 10.5334/jbsr.2112.
7
Cecal Volvulus: A Rare Cause of Intestinal Obstruction.盲肠扭转:肠梗阻的罕见病因。
Case Rep Gastroenterol. 2020 Apr 22;14(1):206-211. doi: 10.1159/000506933. eCollection 2020 Jan-Apr.
8
Acute Colonic Volvulus in a Mexican Population: A Case Series.墨西哥人群中的急性结肠扭转:病例系列
Ann Coloproctol. 2020 Feb;36(1):48-53. doi: 10.3393/ac.2019.01.02. Epub 2020 Feb 18.
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Caecal Volvulus after a dental procedure - not just constipation!牙科手术后发生盲肠扭转——并非仅仅是便秘!
Malays Fam Physician. 2019 Aug 31;14(2):32-35. eCollection 2019.
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American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the management of acute colonic pseudo-obstruction and colonic volvulus.美国胃肠道内镜学会关于内镜在急性结肠假性梗阻和结肠扭转治疗中作用的指南。
Gastrointest Endosc. 2020 Feb;91(2):228-235. doi: 10.1016/j.gie.2019.09.007. Epub 2019 Nov 30.