Ecker K W, Schmid T, Omlor G, Seitz G
Abteilung für Allgemeine, Abdominal- und Gefässchirurgie, Chirurgische Universitätsklinik Homburg/Saar.
Z Gastroenterol. 1993 Mar;31(3):205-9.
Investigating three patients with longstanding diarrhoea, severe abdominal bloating and cramps revealed an exclusion of the right hemicolon in all patients and additionally of the terminal ileum in one of them. The anastomosis of the ileo-colic bypass, performed decades ago due to complicated appendicitis, was stenotic in two of them. Because a classical blind-loop-syndrome could not be proven, the functional disorder is described as a clinical entity characterized by signs of bypass-enteropathy and diversion-colitis. The importance of the radiological examination for diagnosis and therapy-planing is emphasized, because endoscopically and histologically Crohn's disease might be suspected. The surgical reintegration of the bowel into the orthograde continuity of the intestinal tract is recommended as the causative treatment. Symptoms disappear completely and patients win normal health even after some decades, because the morphological signs of inflammation are reversible and bowel function is not lost during the exclusion.
对三名患有长期腹泻、严重腹胀和腹痛的患者进行检查发现，所有患者的右半结肠均被排除在外，其中一名患者的回肠末端也被排除。数十年前因复杂性阑尾炎进行的回结肠旁路吻合术，在其中两名患者中出现狭窄。由于无法证实存在典型的盲袢综合征，这种功能障碍被描述为一种以旁路性肠病和改道性结肠炎体征为特征的临床实体。强调了放射学检查对诊断和治疗规划的重要性，因为在内镜检查和组织学检查中可能会怀疑克罗恩病。建议将肠道手术重新整合到肠道的顺行连续性中作为病因治疗。症状会完全消失，即使在几十年后患者也能恢复正常健康，因为炎症的形态学迹象是可逆的，并且在排除期间肠道功能不会丧失。
