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当肠道误入右侧歧途:一例罕见并发症的病例报告——合并中肠旋转不良的右十二指肠旁疝致闭环性小肠梗阻伴小肠扭转

When the Gut Took a Wrong Turn to the Right: A Case Report of a Rare Complication of Closed Loop Small Bowel Obstruction With Small Bowel Volvulus in a Right Paraduodenal Hernia With Midgut Malrotation.

作者信息

H Samanvitha, Puttappa Shivagange Sushmitha, Sajjan Shantkumar S, G Naveen S, T Harsha M

机构信息

Department of Diagnostic Radiology, Bangalore Medical College and Research Institute, Bengaluru, IND.

Department of Diagnostic Radiology, People Tree Hospital, Bengaluru, IND.

出版信息

Cureus. 2024 Jan 31;16(1):e53342. doi: 10.7759/cureus.53342. eCollection 2024 Jan.

Abstract

Internal hernias constitute 5.8% of all small bowel obstructions. The right paraduodenal hernia is a less common subtype of the paraduodenal hernia. Lack of specific signs and symptoms precludes its clinical diagnosis, which emphasizes the need for computed tomography in diagnosis. We present a case of a 24-year-old male patient with a right paraduodenal hernia and midgut malrotation causing closed loop small bowel obstruction and small bowel volvulus within the hernial sac who underwent laparoscopy-assisted reduction of hernia and adhesiolysis with closure of the peritoneal defect. Since the right paraduodenal hernia is associated with gut malrotation, risk of strangulation, closed-loop obstruction, and rarely volvulus, these patients need prompt radiological diagnosis and surgical intervention.

摘要

内疝占所有小肠梗阻病例的5.8%。右十二指肠旁疝是十二指肠旁疝中较罕见的一种亚型。缺乏特异性体征和症状使其难以进行临床诊断,这凸显了计算机断层扫描在诊断中的必要性。我们报告一例24岁男性患者,患有右十二指肠旁疝和中肠旋转不良,导致疝囊内闭袢性小肠梗阻和小肠扭转,该患者接受了腹腔镜辅助下疝复位及粘连松解术,并封闭了腹膜缺损。由于右十二指肠旁疝与肠道旋转不良、绞窄风险、闭袢性梗阻以及罕见的扭转相关,这些患者需要及时进行影像学诊断和手术干预。

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