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盲肠扭转的微创治疗方法:结肠镜检查的一种罕见并发症

A Minimally Invasive Approach to Caecal Volvulus: A Rare Complication of Colonoscopy.

作者信息

Heath David, Kim Kyungchul, Solomon David J, Jacob Abraham

机构信息

General Surgery, Bunbury Regional Hospital, Perth, AUS.

General Surgery, Rockingham General Hospital, Perth, AUS.

出版信息

Cureus. 2025 Nov 3;17(11):e96046. doi: 10.7759/cureus.96046. eCollection 2025 Nov.

DOI:10.7759/cureus.96046
PMID:41200263
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12587080/
Abstract

Caecal volvulus following colonoscopy represents an extremely rare complication with only a few cases documented in the literature. We report the case of a 67-year-old woman who developed caecal volvulus 24 hours following routine colonoscopy with polypectomy. The patient presented with progressive cramping abdominal pain and nausea. Computed tomography revealed caecal displacement to the right upper abdomen without proximal ascending colon distension. Laparoscopic exploration confirmed caecal volvulus with ischaemia but no perforation. A laparoscopic right hemicolectomy was successfully performed, representing the first reported case managed with this minimally invasive approach. The patient recovered without complications and was discharged on postoperative day 5. This case emphasises the importance of maintaining high clinical suspicion for caecal volvulus in patients presenting with abdominal pain following colonoscopy. Early recognition and prompt laparoscopic intervention can prevent progression to bowel necrosis and perforation while offering superior outcomes compared to traditional open surgical approaches. The minimally invasive technique provides excellent visualisation, reduced morbidity, and faster recovery times, establishing it as the preferred management approach when surgical expertise is available.

摘要

结肠镜检查后发生盲肠扭转是一种极其罕见的并发症,文献中仅有少数病例记载。我们报告一例67岁女性患者,在常规结肠镜检查并息肉切除术后24小时发生盲肠扭转。患者表现为进行性绞痛性腹痛和恶心。计算机断层扫描显示盲肠移位至右上腹,近端升结肠无扩张。腹腔镜探查证实盲肠扭转伴缺血但无穿孔。成功实施了腹腔镜右半结肠切除术,这是首例采用这种微创方法治疗的病例报告。患者恢复良好,无并发症,术后第5天出院。该病例强调了对结肠镜检查后出现腹痛的患者保持高度临床怀疑盲肠扭转的重要性。早期识别并及时进行腹腔镜干预可防止病情进展为肠坏死和穿孔,同时与传统开放手术方法相比,可提供更好的治疗效果。微创技术提供了极佳的视野、降低了发病率并缩短了恢复时间,在具备手术专业知识的情况下,已成为首选的治疗方法。

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本文引用的文献

1
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.
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Acute cecal volvulus: A diagnostic and therapeutic challenge in emergency: A case report.急性盲肠扭转:急诊中的诊断与治疗挑战:一例病例报告
Ann Med Surg (Lond). 2019 Oct 31;48:69-72. doi: 10.1016/j.amsu.2019.10.021. eCollection 2019 Dec.
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Cecal volvulus.盲肠扭转
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Gangrenous cecal volvulus complicating puerperium: is the delay in diagnosis really inevitable?坏疽性盲肠扭转并发产褥期:诊断延迟真的不可避免吗?
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Laparoscopic vs open appendectomy in obese patients: outcomes using the American College of Surgeons National Surgical Quality Improvement Program database.腹腔镜与开腹阑尾切除术治疗肥胖患者的比较:美国外科医师学会国家手术质量改进计划数据库的结果。
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Findings of cecal volvulus at CT.CT 发现盲肠扭转。
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World J Gastroenterol. 2009 May 28;15(20):2547-9. doi: 10.3748/wjg.15.2547.
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Laparoscopic cecopexy for mobile cecum syndrome manifesting as cecal volvulus: report of a case.腹腔镜盲肠固定术治疗以盲肠扭转形式表现的游动盲肠综合征:病例报告
Surg Today. 2008;38(4):359-62. doi: 10.1007/s00595-007-3620-7. Epub 2008 Mar 27.