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胃十二指肠套叠:两例胃折叠术后发生胃十二指肠套叠,分别采用不同方法处理:病例报告

Gastroduodenal intussusception: two cases of gastroduodenal intussusception following gastric plication, each managed with a different approach: a case report.

作者信息

Almowaqee Bassel, Madi Yamen, Taleb Bushra, Haj Oughli Mhd Adnan

机构信息

General Surgery Department, Ibn Al Nafees Hospital, Damascus, Syria.

出版信息

Ann Med Surg (Lond). 2025 Feb 11;87(2):1057-1064. doi: 10.1097/MS9.0000000000002946. eCollection 2025 Feb.

Abstract

INTRODUCTION AND IMPORTANCE

Gastric plication is a bariatric procedure that involves suture imbrication of the greater curvature to restrict the volume of the stomach. Although gastroduodenal intussusception is a complication that surgeons may encounter in their practice, it is rarely reported or published, which limits the available knowledge in medical literature.

CASE PRESENTATION

The authors report two female patients who developed gastroduodenal intussusception following gastric plication procedure, requiring surgical treatment. Both patients presented with non-specific, atypical abdominal pain several months after gastric plication. Both patients required surgical intervention, which included manual reduction of the plication followed by subtotal gastrectomy en bloc with Roux-en-Y reconstruction. In the second case, an omega Braun anastomosis was performed, and a jejunostomy was created after the anastomosis in both patients.

CLINICAL DISCUSSION

The optimal management of gastroduodenal intussusception remains challenging due to the lack of reported cases and the technical difficulties that surgeons may face.

CONCLUSION

It appears that we will encounter some problems and complications in the present time and the near future, including some that are rare in bariatric surgery, particularly those procedures that have fallen out of favor, such as gastric plication surgery.

摘要

引言与重要性

胃折叠术是一种减肥手术,通过对胃大弯进行缝合重叠来限制胃的容积。尽管胃十二指肠套叠是外科医生在实践中可能遇到的一种并发症,但很少有报道或发表,这限制了医学文献中现有的相关知识。

病例报告

作者报告了两名女性患者,她们在接受胃折叠术后发生了胃十二指肠套叠,需要手术治疗。两名患者在胃折叠术后数月均出现非特异性、不典型的腹痛。两名患者均需要手术干预,包括手动复位折叠部分,随后行胃大部切除术并整块切除,并行Roux-en-Y重建。在第二例中,进行了欧米伽·布劳恩吻合术,且两名患者在吻合术后均做了空肠造口术。

临床讨论

由于报道的病例较少以及外科医生可能面临的技术难题,胃十二指肠套叠的最佳治疗方法仍然具有挑战性。

结论

目前及不久的将来,我们似乎会遇到一些问题和并发症,包括减肥手术中一些罕见的问题,尤其是那些已不再流行的手术,如胃折叠术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fd5/11918730/f061a8f1e39f/ms9-87-1057-g001.jpg

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