Killebrew L H, Kukora J S
Arch Surg. 1983 Jul;118(7):875-7. doi: 10.1001/archsurg.1983.01390070083018.
Intestinal obstruction in adults caused by congenital duodenal webs is uncommon. Roentgenographic and endoscopic diagnosis is difficult owing to frequently nonspecific roentgenographic findings and the obliteration of normal pyloric endoscopic anatomy. The ultimate diagnosis of this lesion is likely to be made at the time of cellotomy for suspected obstructing peptic ulcer disease with the observation of an unobstructed pylorus. We studied three recent cases and reviewed the pertinent literature, which demonstrated problems associated with preoperative and surgical diagnosis and management. Diagnosis of duodenal webs should be suspected in all patients with gastric or high duodenal obstruction and investigated by digital duodenal exploration at the time of surgery.
先天性十二指肠蹼导致的成人肠梗阻并不常见。由于X线检查结果常常不具有特异性，且正常幽门的内镜解剖结构消失，因此X线和内镜诊断都很困难。这种病变的最终诊断很可能是在因疑似梗阻性消化性溃疡疾病而进行剖腹探查时，观察到幽门未梗阻时做出的。我们研究了最近的三例病例并回顾了相关文献，这些文献显示了与术前及手术诊断和治疗相关的问题。对于所有患有胃或十二指肠高位梗阻的患者，都应怀疑十二指肠蹼的诊断，并在手术时通过手指探查十二指肠进行检查。
