目的探討成人回腸重復(fù)畸形的臨床診斷和治療方法。 方法收集1996年2月至2010年12月,我院收治的6例回腸重復(fù)畸形患者的臨床資料,并結(jié)合相關(guān)文獻(xiàn)對該病的診治方法進(jìn)行分析與討論。 結(jié)果本組6例回腸重復(fù)畸形患者均為男性, 臨床表現(xiàn)主要為消化道出血、腹痛、腸梗阻和腹部包塊。其中5例行胃鏡、結(jié)腸鏡及腹部CT檢查,3例行腸系膜動脈造影檢查,均未提示消化道重復(fù)畸形; 4例行99Tcm放射性核素顯像檢查,其中2例提示消化道出血; 3例行雙氣囊小腸鏡檢查,1例發(fā)現(xiàn)雙回腸畸形。術(shù)前均未明確診斷,僅1例考慮回腸重復(fù)畸形可能。6例均行手術(shù)治療,術(shù)中發(fā)現(xiàn)距回盲部11~100 cm范圍內(nèi)有長度為6~25 cm的重復(fù)腸管。術(shù)后病理檢查證實均為回腸重復(fù)畸形,其中2例見胃黏膜異位,2例見腸腔內(nèi)憩室,1例并發(fā)異位胰腺,1例伴回盲部炎性纖維性假瘤。 6例患者術(shù)后均恢復(fù)良好。 結(jié)論成人回腸重復(fù)畸形極為少見,臨床無特異表現(xiàn),目前暫無敏感性及特異性高的輔助檢查,雙氣囊小腸鏡及99Tcm放射性核素顯像有一定提示意義。術(shù)前一般很難作出明確診斷。 剖腹探查時應(yīng)考慮到該病的可能,一旦發(fā)現(xiàn),建議手術(shù)切除。
引用本文: 黃欣,李秉璐,周皎琳,肖毅,趙玉沛. 成人回腸重復(fù)畸形的診治體會. 中國普外基礎(chǔ)與臨床雜志, 2011, 18(11): 1200-1204. doi: 復(fù)制
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14. | 秦高平, 王小強(qiáng), 遲達(dá)超, 等. 成人小腸重復(fù)畸形致消化道出血1例 [J]. 陜西醫(yī)學(xué)雜志, 2007, 36 (2): 255256. |
15. | 彭穎, 王立新, 張能維, 等. 成人回腸重復(fù)畸形潰瘍穿孔伴多重畸形一例 [J]. 中華普通外科雜志, 2005, 20(10: 659660. |
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20. | 岑曉紅, 李愛美, 錢振育. 雙氣囊電子小腸鏡26例分析 [J]. 中國誤診學(xué)雜志, 2009, 9(1): 197198. |
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- 1. 徐春岳. 6例成人腸重復(fù)畸形診治體會 [J]. 臨床醫(yī)學(xué), 2002, 22(2): 2627.
- 2. Johnson JA 3rd, Poole GV. Ileal duplications in adults. Presentation and treatment [J]. Arch Surg, 1994, 129(6): 659661.
- 3. 毛一雷, 朱峰, 杜順達(dá), 等. 成人回腸重復(fù)畸形的診斷和治療 [J]. 中國臨床營養(yǎng)雜志, 2006, 14(5): 300302.
- 4. Hackam DJ, Zalev A, Burnstein M, et al. Enteric duplication in the adult, derived from the foregut, midgut and hindgut: presentation, patterns and literature review [J]. Can J Surg, 1997, 40(2): 129133.
- 5. Azzie G, Beasley S. Diagnosis and treatment of foregut duplications [J]. Semin Pediatr Surg, 2003, 12(1): 4654..
- 6. 趙玉元. 腸重復(fù)畸形合并急性并發(fā)癥的診斷與治療 [J]. 中華胃腸外科雜志, 2007, 10(2): 114.
- 7. Ladd AP, Grosfeld JL. Gastrointestinal tumors in children and adolescents [J]. Semin Pediatr Surg, 2006, 15(1): 3747.
- 8. 趙玉元. 64例腸重復(fù)畸形的外科治療 [J]. 臨床小兒外科雜志, 2007, 6(2): 1214.
- 9. Chen CC, Yeh DC, Wu CC, et al. Huge cystic duplication of the ascending colon in adult [J]. Zhonghua Yi Xue Za Zhi (Taipei), 2001, 64(3): 174178.
- 10. Kim SK, Lim HK, Lee SJ, et al. Completely isolated enteric duplication cyst: case report [J]. Abdom Imaging, 2003, 28(1): 1214..
- 11. Daudet M, Chappuis JP, Daudet N. Symposium on intestinal duplications [J]. Ann Chir Infant, 1967, 8(1): 580.
- 12. Iyer CP, Mahour GH. Duplications of the alimentary tract in infants and children [J]. J Pediatr Surg, 1995, 30(9): 12671270.
- 13. Puligandla PS, Nguyen LT, StVil D, et al. Gastrointestinal duplications [J]. J Pediatr Surg, 2003, 38(5): 740744..
- 14. 秦高平, 王小強(qiáng), 遲達(dá)超, 等. 成人小腸重復(fù)畸形致消化道出血1例 [J]. 陜西醫(yī)學(xué)雜志, 2007, 36 (2): 255256.
- 15. 彭穎, 王立新, 張能維, 等. 成人回腸重復(fù)畸形潰瘍穿孔伴多重畸形一例 [J]. 中華普通外科雜志, 2005, 20(10: 659660.
- 16. 李巍, 冀明, 張澍田. 成人回腸重復(fù)畸形合并消化道出血1例 [J]. 胃腸病學(xué), 2010, 15(6): 383384.
- 17. 李承念. 成人回腸重復(fù)畸形并急性闌尾炎一例 [J]. 臨床外科雜志, 2009, 17(2): 87.
- 18. Hwang IK, Namkung S, Kim BS, et al. Perforated ileal duplication cyst with haemorrhagic pseudocyst formation [J]. Pediatr Radiol, 2003, 33(7): 489491..
- 19. Ogino H, Ochiai T, Nakamura N, et al. Duplication cyst of the small intestine found by doubleballoon endoscopy: a case report [J]. World J Gastroenterol, 2008, 14(24): 39243926.
- 20. 岑曉紅, 李愛美, 錢振育. 雙氣囊電子小腸鏡26例分析 [J]. 中國誤診學(xué)雜志, 2009, 9(1): 197198.
- 21. AlSarem SA, AlShawi JS. Ileal duplication in adults [J]. Saudi Med J, 2007, 28(11): 17341736.