Robert M, Maurage C, Lacombe A, Mercier C
Chir Pediatr. 1983;24(2):148-51.
A case of gastroschisis and double small bowel atresia is reported. Primary surgical treatment consisted in jejunostomy located at 28 cm from the ligament of Treits, reinstatement of excluded bowel loops encased in a thick matrix of fibrinous material, and abdominal wall closure. Seven weeks later, the lower part of small bowel was anastomosed to the medium part. Because of uneven bowel caliber, an ileostomy was associated to parenteral nutrition using permanent instillation of secretions recovered from ileostomy was associated to parenteral nutrition. At 4 1/2 month, small bowel continuity was restored with jejunal modeling. Authors stress the necessity to preserve as far as possible, intestinal segments in such a case and emphasize the advantage of the digestive instillation method in order to recover the function excluded intestinal segments.
报道了一例腹裂合并双小肠闭锁的病例。一期手术治疗包括在距屈氏韧带28厘米处进行空肠造口术,将包裹在厚厚的纤维蛋白物质基质中的排除肠袢复位,以及腹壁关闭。七周后,小肠下部与中部进行吻合。由于肠管口径不均匀,回肠造口术与肠外营养相关,使用从回肠造口术回收的分泌物进行持续滴注与肠外营养相关。在4个半月时,通过空肠塑形恢复了小肠连续性。作者强调在这种情况下尽可能保留肠段的必要性,并强调消化滴注法在恢复排除肠段功能方面的优势。