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一个乳头-门袋做扭曲 (有视频)
Flore de Castelbajac1, Nicolas Billet1, Laurence Monnier-Chollet1
1Centre for Digestive Endoscopy, APHP, Saint Antoine Hospital, Sorbonne University, Paris, France.
Clinics and research in hepatology and gastroenterology
|December 8, 2024
概括
一个罕见的扭曲综合征病例,或叶J袋的卷发,通过紧急内镜成功治疗. 这种最少的侵入性方法解开了袋子,缓解了急性阻塞并防止了手术的需要.
科学领域:
- 胃肠病学 胃肠病学
- 外科胃肠道外科手术
- 医疗成像医学成像
背景情况:
- 克罗恩氏病患者经历了带有叶J-袋-门解剖体的直肠切除术,面临着袋子并发症的风险.
- 急性阻塞性症状可能来自各种囊袋问题,包括,通常称为"扭曲综合征".
研究的目的:
- 报告一个急性阻塞性症状的病例,原因是伊莱尔J-袋卷积.
- 突出紧急内镜在治疗这种罕见并发症中的诊断和治疗作用.
主要方法:
- 一名37岁的女性有史以来克罗恩病和J-袋门缩,出现了急性阻塞性症状.
- 计算机断层扫描 (CT) 扫描显示,伊利奥关节的扭转为180度.
- 紧急下部内镜进行,以解开J袋,然后放置多孔法舍管.
主要成果:
- 对J袋的内镜解和随后的管道放置提供了立即的症状缓解.
- 患者在手术后两天出院,在60天的随访中没有复发.
- 这一案例强调了对J-pouch volvulus的非手术内镜治疗的有效性.
结论:
- 紧急内镜是诊断和治疗J-袋卷发症的关键工具,为手术提供了最少侵入性的替代方案.
- 结合CT扫描和内镜的及时诊断对于成功的袋子救援至关重要.
- 虽然可以考虑进行手术修复以预防,但内镜解可以有效地管理急性发作.
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