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复发性乙状结肠扭转导致纵隔和气管移位:一例报告

Mediastinal and tracheal shift due to recurrent sigmoid volvulus: A case report.

作者信息

Yasin Mensur Osman, Assefa Mezgebu Alemneh, Alemu Hirut Tesfahun, Molla Yohannis Derbew

机构信息

Department of Surgery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

SAGE Open Med Case Rep. 2024 Apr 10;12:2050313X241246658. doi: 10.1177/2050313X241246658. eCollection 2024.

Abstract

We hereby present a 70-year-old male Ethiopian farmer who presented with clinical manifestations suggestive of acute large bowel obstruction, which had persisted for 3 days. Over the past 3 years, he has experienced three similar recurring episodes, which were alleviated by decompression using a rectal tube. Upon initial examination, the patient displayed signs of cardiopulmonary distress, although no indications of peritonitis were observed. Further evaluation through plain abdominal and chest X-rays revealed findings consistent with sigmoid volvulus, as well as mediastinal shift, elevated diaphragm, and a right-positioned heart. Consequently, a sigmoid resection and an end colostomy were done. The patient showed improvement and was discharged from the hospital on the 14th day following the surgery. It is atypical for an individual to present with acute sigmoid volvulus accompanied by a mediastinal shift resulting from mass action on the hemidiaphragm. Therefore, it may be imperative to involve a pulmonologist in managing this rare situation. By ensuring that the surgical team is well-informed in such circumstances, patients can receive enhanced care and treatment.

摘要

我们在此介绍一位70岁的埃塞俄比亚男性农民,他出现了提示急性大肠梗阻的临床表现,这种情况已持续3天。在过去3年里,他经历了三次类似的复发发作,通过使用直肠管减压得以缓解。初次检查时,患者表现出心肺窘迫的迹象,尽管未观察到腹膜炎的迹象。通过腹部和胸部平片进一步评估发现与乙状结肠扭转相符的表现,以及纵隔移位、膈肌抬高和心脏右位。因此,进行了乙状结肠切除术和末端结肠造口术。患者情况好转,术后第14天出院。一个人出现急性乙状结肠扭转并伴有因对半侧膈肌的肿块作用导致的纵隔移位是不典型的。因此,在处理这种罕见情况时可能有必要让肺科医生参与。通过确保手术团队在这种情况下充分了解情况,患者可以得到更好的护理和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5efe/11008338/281841ca4f11/10.1177_2050313X241246658-fig1.jpg

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