Starkloff G B, Shively R A, Gregory J G
Ann Surg. 1977 Apr;185(4):386-90. doi: 10.1097/00000658-197704000-00002.
In 600 patients who have undergone small bowel bypass for the treatment of morbid obesity, we have encountered three patients who developed intussusception in the bypassed intestine. Diagnosis in these cases has been difficult but in two patients with surgical marker clips applied to the transected fixed jejunum as well as to the adjacent mesocolon, diagnosis was made easier by the radiographic finding of separation of these clips. Clinical symptoms are difficult to evaluate and valuable time may be wasted before a diagnosis is arrived at. Once a diagnosis is made, operation with either reduction or resection of the area of intussusception should be carried out with refixation of the bowel to the mesocolon and reapplication of surgical marker clips. These marker clips are of great value in the diagnosis of intussusception occurring in the bypassed loop.
在600例接受小肠旁路手术治疗病态肥胖症的患者中，我们遇到了3例在旁路肠段发生肠套叠的患者。这些病例的诊断很困难，但在2例已将手术标记夹应用于横断固定的空肠以及相邻结肠系膜的患者中，通过这些夹子分离的影像学表现使诊断变得更容易。临床症状难以评估，在做出诊断之前可能会浪费宝贵的时间。一旦做出诊断，应进行手术，对肠套叠区域进行复位或切除，并将肠管重新固定于结肠系膜，重新应用手术标记夹。这些标记夹在诊断旁路肠袢发生的肠套叠方面具有重要价值。
