揭示了一个凝聚性灾难:在一个中年患者中,与西格体卷积共存的前皮质穿孔和西格体卷积

Mihir Patil1, Pankaj Gharde1

  • 1General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Cureus
|March 29, 2024
PubMed

乙状结肠扭转是全球结肠梗阻的常见原因,占所有结肠扭转病例的大多数。该病在年龄超过70岁的人群中更为常见。乙状结肠作为大肠的一部分,呈S形,由于其冗长且活动度大,易发生此类情况。治疗包括内镜下复位联合乙状结肠切除术。腹腔镜手术已被证实可减少并发症、出血量、镇痛药物使用及住院时间;相比之下,手术治疗则被发现与较低的复发率相关。早期诊断对于预防并发症和降低复发率至关重要。胃十二指肠穿孔,无论是自发性还是创伤性,主要与消化性溃疡病相关。具体而言,大多数穿孔性消化性溃疡归因于Helicobacter pylori感染。穿孔作为合并症的存在使外科管理复杂化,尤其是在患者有相关病史的情况下H. pylori感染,这在我们的病例中已有体现。处理这些感染对于优化治疗效果和减少潜在并发症至关重要。腹腔镜手术因其优势和更快的恢复期而广受欢迎,尤其是在老年群体中。本病例报告介绍了一名48岁男性患者,因腹痛、多次呕吐、无法排便及腹胀,就诊于我院三级医疗中心。该患者被诊断为乙状结肠扭转合并幽门前穿孔,通过手术治疗,首先进行复位,随后采用改良格雷厄姆补片技术行乙状结肠切除术。术后恢复良好,无任何术后并发症。

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