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由于梅克尔的门被困在超腹性西格结肠术背后引起的小肠阻塞:一个病例报告
Hidenobu Nakagama1, Koji Tamura1, Takaaki Fujimoto1
1Department of Surgery and Oncology, Kyushu University, Fukuoka, Fukuoka, Japan.
Surgical case reports
|March 12, 2026
概括
一个罕见的小肠阻塞 (SBO) 病例发生,原因是梅克尔的分离器被困在一个跨肠结肠架后面. 腹腔镜手术成功地治疗了粘附和分离器,突出显示了微创手术的好处.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 腹部外科手术 腹部外科手术
背景情况:
- 梅克尔分隔膜是一种常见的先天性异常,通常无症状,但可能导致阻塞等并发症.
- 经腹膜结肠静脉切除术 (Transperitoneal colostomy) 经常在腹膜经骨切除术 (APR) 后使用,它会带来小肠阻塞 (SBO) 的风险.
- 由梅克尔的分离器被困在静脉口腔后面引起的SBO是一种未报告的并发症.
研究的目的:
- 报告一种极为罕见的SBO病例,由梅克尔分管附着在横结肠静脉中引起的.
- 讨论腹腔镜在这种情况下的诊断和治疗作用.
- 考虑跨关节与外关节结肠静脉修复路线的解剖学含义.
主要方法:
- 一名70岁的男性接受了机器人辅助的APR,并为直肠癌进行了跨腹膜性西格结肠切除术.
- 手术后10个月,该患者出现了SBO的症状,最初以保守的方式管理.
- laparoscopic 探索显示,梅克尔的分泌体粘附于结肠静脉,导致SBO; 粘合溶解和分泌体切除术进行.
主要成果:
- 该患者经历了SBO,原因是梅克尔的分分管被困在跨关节的西格结肠静脉后面.
- laparoscopic 粘结溶解和分泌器切除术成功进行.
- 患者康复良好,没有SBO的复发.
结论:
- 这一案例突出了SBO的罕见原因,涉及梅克尔的分隔膜和跨关节结肠静脉.
- 额外腹膜外路线可能会降低粘附相关并发症的风险.
- 腹腔镜是有效的诊断和治疗SBO的不确定的病因在后结肠镜设置后.
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