Litschgi M, Käser O
Geburtshilfe Frauenheilkd. 1978 Nov;38(11):915-20.
During the past nine years 70 enteroceles were observed. There were 27 primary and 43 secondary enteroceles. Etiologic factors were multiparity, advanced age, general lack of elasticity, obestiy, constipation and increased intra-abdominal pressure. The pathogenesis of primary enteroceles was usually to do a genital prolapse, tissue atrophy, a distended pouch of Douglas due to a tumour. The pathogenesis of secondary enterocele following previous uterine surgery was that at times the pre-existent enterocele had not been observed and the space between the uterosacral ligament and the rectum not been closed, or the patients had vaginal hysterectomies and anterior and posterior colporrhaphies, or the patients had previous uterine suspensions or abdominal hysterectomies. The interval between uterine surgery and enterocele was a mean 1.5 years for vaginal hysterectomies and a mean 15 years for the other operations. Different operative procedures for enterocele are discussed. In 90% of the cases the enteroceles were repaired vaginally by the method of Shaw O'Sullivan.
在过去九年中，共观察到70例小肠膨出。其中原发性小肠膨出27例，继发性小肠膨出43例。病因包括多产、高龄、普遍缺乏弹性、肥胖、便秘和腹内压升高。原发性小肠膨出的发病机制通常与生殖器脱垂、组织萎缩、因肿瘤导致Douglas窝扩张有关。既往子宫手术后继发性小肠膨出的发病机制是，有时术前存在的小肠膨出未被发现，子宫骶韧带与直肠之间的间隙未闭合，或者患者接受了阴道子宫切除术及阴道前后壁修补术，或者患者曾接受过子宫悬吊术或腹式子宫切除术。子宫手术与小肠膨出之间的间隔时间，阴道子宫切除术平均为1.5年，其他手术平均为15年。文中讨论了小肠膨出的不同手术方法。90%的病例采用Shaw O'Sullivan法经阴道修复小肠膨出。
