成年女性肠旋转不良致盲肠扭转1例报告

Buendia-Garcia Al, H Bizueto-Rosas, N. A. Hernández-Pérez, Bizueto-Blancas Nn, Perez-Gonzalez Ha, Gómez-Calvo Cd, A Jimenez-Canet-Atilano, Caltenco-Solís Rb, A Mijangos-Montano, M Radilla-Flores
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摘要

我们提出的情况下,一个成年妇女的病史,反复发作的肠道亚闭和闭塞与药物治疗缓解。因急性腹痛和继发于CT扫描结果入院时,发现肝十二指肠韧带后短、扩张、扭转的盲肠和塌陷的横结肠旋转异常,需要肠切除术和回结肠原发肠吻合,决定紧急手术。结论:反复肠闭塞和亚封闭症状也出现在有反复发作史的成人患者中,且一直保守治疗,应考虑可能的旋转不良异常。盲肠扭转是一种非常罕见的临床疾病,难以早期诊断,可能与旋转异常有关。这类患者的早期手术采用保守治疗,需要高度的诊断怀疑指数,但与较低的死亡率和发病率相关。
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Volvulus of the Cecum Due to Intestinal Malrotation in an Adult Woman, a Case Report
We present the case of an adult woman with a medical history of repetitive episodes of intestinal subocclusion and occlusion that remitted with medical treatment. During hospital admission due to acute abdominal pain and secondary to CT scan results, an urgent surgical approach was decided with findings of a malrotation anomaly consisting in a short, dilated and volvulus cecum behind hepatoduodenal ligament and a collapsed transversal colon, requiring intestinal resection and ileocolic primary intestinal anastomosis. Conclusion: Repetitive intestinal occlusion and subocclusion symptoms also in an adult patient with history of repetitive episodes that were always treated conservatively should be considered as a possible malrotation anomaly. Cecal volvulus is a very rare clinical entity, difficult to early diagnose and can be associated to a malrotation anomaly. Early surgery in this types of patients, that are used to conservative treatment, require a high index of diagnostic suspicion but can be associated with lower mortality and morbidity.
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