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伴有小肠梗阻的复杂性空肠憩室炎:一例报告。 因肠石引起

Complicated jejunal diverticulitis with small bowel obstruction due to enterolith: A case report.

作者信息

Barnard Paige, Wilson Katherine

机构信息

Sunshine Coast University Hospital (SCUH), 6 Doherty Street, Birtinya, QLD 4575, Australia.

Sunshine Coast University Hospital (SCUH), 6 Doherty Street, Birtinya, QLD 4575, Australia.

出版信息

Int J Surg Case Rep. 2023 Oct;111:108896. doi: 10.1016/j.ijscr.2023.108896. Epub 2023 Oct 4.

Abstract

INTRODUCTION AND IMPORTANCE

Small bowel diverticular disease (DD) is encountered and managed much less frequently than colonic DD, leading to a significantly less developed body of evidence for managing small bowel diverticulum and its associated complications.

CASE PRESENTATION

This case report discusses a rare occurrence of simultaneous perforated jejunal diverticulitis and mechanical small bowel obstruction (SBO) due to a migrating diverticular enterolith. The patient's condition was ultimately managed operatively through laparoscopically assisted small bowel resection.

CLINICAL DISCUSSION

A review of the literature reveals only eight reported cases of jejunal diverticulitis with simultaneous enterolith obstruction. All cases were managed operatively, with approaches including small bowel resection encompassing both pathologies, milking the enterolith back to the diverticulitis site and resecting en bloc to avoid extensive resection, or enterotomy and enterolith retrieval.

CONCLUSION

The prevalence of small bowel diverticular disease is increasing, and as a result, clinicians may encounter more complications associated with this condition in the future. This case highlights the importance of considering alternate complications of small bowel DD.

摘要

引言与重要性

小肠憩室病(DD)的诊治比结肠DD少见得多,这导致关于小肠憩室及其相关并发症管理的证据体系远未完善。

病例介绍

本病例报告讨论了一种罕见情况,即因迁移性憩室肠石导致空肠憩室炎并发穿孔及机械性小肠梗阻(SBO)。患者最终通过腹腔镜辅助小肠切除术进行手术治疗。

临床讨论

文献回顾显示,仅报告了8例空肠憩室炎合并肠石梗阻的病例。所有病例均采用手术治疗,方法包括切除包含两种病变的小肠、将肠石挤回憩室炎部位并整块切除以避免广泛切除,或进行肠切开取石。

结论

小肠憩室病的患病率正在上升,因此,临床医生未来可能会遇到更多与此疾病相关的并发症。本病例强调了考虑小肠DD其他并发症的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa76/10568270/b84bde0a84f5/gr1.jpg

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