案例报告:骨诱导的十二指甲分离器在第三部分的穿孔成功通过内镜治疗
Hui-Hui Zhou1, Cui-Mei Ma1, Yan Wang1
1Department of Gastroenterology, Affiliated Hospital of Jining Medical University, Jining, China.
Frontiers in medicine
|October 24, 2025
概括
从第三部分 (D3) 的穿孔十二指肠分流体内检取出一块骨,成功治疗了一种罕见的紧急情况. 这种最少的侵入性方法为复杂的十二指肠疾病的手术提供了一个有希望的替代方案.
科学领域:
- 胃肠病学 胃肠病学
- 最少侵入性的手术
- 内镜治疗药物 内镜治疗药物
背景情况:
- 十二指甲 (DD) 穿孔是一种罕见的,高死亡率的紧急情况,最常见的是第二个十二指甲 (D2).
- 第三个十二指肠部分 (D3) 脱管是不常见的,带来独特的诊断和治疗挑战.
- 对于DD穿孔的传统治疗包括保守的管理,排水或手术,每个都有相关的风险.
研究的目的:
- 报告一个成功的内镜干预案例,用于D3.3中穿孔的十二指甲分离器.
- 突出最小侵入性内镜技术在处理复杂的十二指甲孔穿孔的有效性.
- 扩大内镜治疗的应用到罕见的D3穿孔.
主要方法:
- 在保守治疗失败后,一名71岁的男性怀疑D3穿孔分歧管和异物经历了内镜干预.
- 一个带有透明盖的胃镜被用来去除嵌入的骨和碎片.
- 由此产生的管用金属片成功地关闭了.
主要成果:
- 在技术上,内镜外体去除和囊关闭是成功的.
- 术后的CT扫描显示了显著的改善.
- 患者在18个月的随访期间仍然没有症状,没有复发.
结论:
- 内镜治疗是对D3十二指甲穿孔的可行和有效的选择,特别是在涉及异物时.
- 最少侵入性内镜治疗比传统手术具有优势,包括减少并发症和更快的恢复.
- 这一案例证明了内镜在治疗复杂的十二指肠疾病中的作用不断扩大,并为未来的干预提供了宝贵的见解.
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