成年人逆转时的十二指甲管狭窄:当拉德手术不够时:一个病例报告
Ebenezer Akomea-Agyin1, Kwabena Agbedinu1, Charles Kofi Dally1
1Komfo Anokye Teaching Hospital, Directorate of Surgery, P.O. Box 1934, Kumasi, Ghana.
International journal of surgery case reports
|May 4, 2024
概括
成年人肠道转变不良和十二指肠狭窄可以同时存在,导致持续的症状. 拉德手术可能无法解决所有问题,但将其与Heineke-Mikulicz狭窄整形手术相结合,可以实现完全缓解症状.
科学领域:
- 胃肠病学 胃肠病学
- 外科胃肠道外科手术
- 儿科手术 儿科手术
背景情况:
- 先天性十二指管阻塞源于内在或外在的原因,影响症状的严重程度和呈现时间.
- 高度阻塞,如动脉障碍在新生儿时被诊断出来,而低度障碍,如旋转不良和狭窄,可能会持续到成年.
研究的目的:
- 报告一个同时存在的成年肠道恶性转变和十二指肠狭窄的病例.
- 突出结合手术治疗持续阻塞性症状的有效性.
主要方法:
- 一名24岁的女性出现了急性-慢性腹痛和胆汁性吐.
- 最初的诊断是间歇性小肠卷发症,用拉德手术治疗恶性旋转.
- 通过Heineke-Mikulicz狭窄整形术对十二指肠狭窄的后续诊断和手术治疗.
主要成果:
- 患者在最初的拉德手术后经历了持续的阻塞症状.
- 转皮切除术揭示了由于纤维化导致的十二指甲管狭窄.
- 亨尼克-米库利茨狭窄整形术导致症状完全消失.
结论:
- 部分十二指管阻塞的先天性内在 (十二指管狭窄) 和外在 (恶转) 原因可以在成年人中并存.
- 手术纠正必须解决两种条件,以完全消除症状.
- 亨尼克-米库利茨狭窄整形手术是一种有价值的补充手术,用于在Ladd手术后持续的症状,在联合不良旋转和狭窄的情况下.
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