柿石性肠梗阻39例诊治报告

1994～2 0 0 1年我院共收治柿石性肠梗阻39例,报告如下。临床资料本组男2 3例,女16例,男∶女为1 5∶1,年龄4～6 2岁,12岁以下2 5例,平均年龄11 5岁。患者均有1次或多次进食柿子10 0～5 0 0 g。肠梗阻部位:空肠15例,回肠2 4例。进食柿子至发病时间为3～90d ,平均7d ,发病至入院时间2h～7d ,平均2d。本组腹痛39例(10 0 % ) ,呕吐2 6例(6 7% ) ,腹胀12例(31% ) ,腹部包块6例(15 % ) ,停止排气排便14例(36 % ) ,腹透有多个液气平面30例(77% )。本组入院时明确诊断者2 5例,入院后2 4h内行手术治疗。以不完全性肠梗阻入院者5例,经保守治疗2～3d ,…     

柿石性肠梗阻39例诊治报告

目的探讨柿石性肠梗阻的诊治措施.方法收集自1994年1月～2001年12月间收治的39例柿石性肠梗阻的临床资料,分析其诊治过程中的相关问题.结果经手术治疗,所有病例获得痊愈出院.结论柿石性肠梗阻多发生于小肠,且容易多发,一旦明确诊断应及早手术治疗.     

柿石性肠梗阻39例诊治报告

目的探讨柿石性肠梗阻的诊治措施。方法收集自1994年1月～2001年12月间收治的39例柿石性肠梗阻的临床资料,分析其诊治过程中的相关问题。结果经手术治疗,所有病例获得痊愈出院。结论柿石性肠梗阻多发生于小肠,且容易多发,一旦明确诊断应及早手术治疗。     

柿石性肠梗阻的诊治

回顾性分析笔者收治的11例柿石性肠梗阻患者的临床资料。全组8例>60岁;均有进食生柿子史,病程1d至3个月,均有肠梗阻表现;11例均经手术治愈。提示柿石性肠梗阻多见于老年人,一般表现为单纯性肠梗阻。经保守治疗24~78h无效时应果断手术,手术方法为切开肠管取粪石,术中应行从胃到回盲部全面探查。     

36 柿石性肠梗阻的诊治

回顾性分析笔者收治的11例柿石性肠梗阻患者的临床资料。全组8例>60岁；均有进食生柿子史，病程1d至3个月，均有肠梗阻表现；11例均经手术治愈。提示柿石性肠梗阻多见于老年人，一般表现为单纯性肠梗阻。经保守治疗24~78h无效时应果断手术，手术方法为切开肠管取粪石，术中应行从胃到回盲部全面探查。     

柿石性小肠梗阻10例诊治体会

我院于1994年3月至2008年10月收治柿石性小肠梗阻10例,现报告如下。 临床资料 1．一般资料：本组10例中,男性9例,女性1例;年龄61～85岁;病程1周～3个月。本组临床上均表现为肠梗阻症状,发病前均有食大量柿子。     

胃小肠柿石并柿石性小肠梗阻一例

<正>病人，男性，70岁。1天前无明显诱因上腹部胀痛不适，左上腹明显，无放射性疼痛，肛门停止排气排便，无黑便及血便，伴恶心、呕吐，呕吐物为胃内容物，无咖啡渣样物质，在家未行特殊治疗，后腹痛逐渐加重，遂于2018年9月29日急来院就诊。既往十二指肠球部溃疡、胃结石，结石性质不清，未行特殊处理，既往高血压病史。入院后补充病史，病人半月前曾进食柿子。入院当日实验室检查：白细胞13.11×10⁹/L,中性粒细胞11.35×10⁹/L ,中性粒细胞百分     

输尿管肾盂连接部梗阻46例诊治体会

1 临床资料 我院1998-02～2001-12共收治输尿管肾盂连接部梗阻(UPJO)患者46例,左侧32例,右侧14例,男30例,女16例,年龄10～68(平均38.5)岁。病程10月～3年,平均18月。所有病例均行B超、KUB、IVU检查,RP 18例,经皮肾盂穿刺造影术10例,CT检查10例。患肾均有中重度积水,合并有肾结石3例,肾盂肾炎12例。     

柿石性肠梗阻2次手术一例

患者男，68岁。因腹痛、腹胀并肛门停止排气、排便2d于2006年10月14日入院。入院前20d，患者曾空腹进食大量新鲜柿子。查体：全腹膨隆．可见肠型及蠕动波，未及腹部包块，肠鸣音亢进，可闻及气过水声。腹部立位X摄片：小肠梗阻。于2006年10月15日急诊行剖腹探查．术中发现距回盲部40cm回肠处粪石阻塞于肠腔内，其近端小肠明显扩张，远端空虚，遂行小肠切开，     

十二指肠梗阻诊治的要点

十二指肠梗阻的特点是多为慢性、不完全性、持续性或间歇性的排空受　阻，往往呈现十　二指肠不同程度的代偿性扩张。由于十二指肠位置与周围器官具有特殊性，梗阻的病因多种　，比较复杂，因此在诊断和治疗上独具特性，应抓住其诊治要点。诊断十二指肠梗阻的诊断并不困难。由于十二指肠位置及周围器官独具特性，病因复杂，所以　要明确引起梗阻的原因较为困难。一般来说十二指肠梗阻多为慢性不完全梗阻，可逐渐加重　或反复发作的疼痛、呕吐。如梗阻部位在十二指肠乳头远侧，则呕吐物含有胆汁为其　特点，以此可鉴别是十二指肠梗阻抑或为…     

Small bowel obstruction due to phytobezoars in the intact gastrointestinal tract

We present a series of cases of small bowel obstruction due to an intraluminal phytobezoar concretion. This rare cause of obstruction should not be forgotten as the recent literature has concentrated more on those patients with a past history of gastrointestinal surgery. None of our cases had had previous surgery, highlighting the point that an intact gastrointestinal tract does not exclude phytobezoars as a cause of obstruction.     

Treatment of biliary obstruction caused by metastatic cancer

Over an 8-year period, among 41 patients with obstructive jaundice caused by metastases to the liver or lymph nodes adjacent to the porta hepatis, palliative biliary decompression was established surgically in 11, by percutaneous transhepatic biliary drainage (PTBD) in 25, and by both methods in 2. Three patients had no drainage procedure performed. Early mortality after drainage occurred in 6 of 38 patients, and the median survivals (actuarial) for the remaining 32 patients were 4.5 months for the surgical group (range 2 to 21 months) and 4 months for the PTBD group (range 2 to 14 months). Although there were trends toward more frequent hospital readmissions and episodes of cholangitis in the PTBD group, the only statistically significant difference was in the number of catheter manipulations required. We concluded that when patients develop obstructive jaundice as a manifestation of metastatic cancer, useful palliation can be achieved by either surgical or percutaneous decompression.     

膜性布加综合征480例的治疗分析

目的：探讨膜性布－加综合征的最佳治疗方法，方法：对480例膜性布－加综合征患者手术的长期疗效和复发情况进行回顾性分析。结果：破膜组52例，随访率84．62％（44／52），随访时间6个月至10年，有效率61．4％，复发率38．6％，介入组238例，随访率86．55％（206／238），随访时间6个月至8年，有效率91．7％，复发17例，复发率8．3％，根治组190例，随访率87．37％（166／190），随访时间9个月至8年，有效率90．4％，复发率9．6％，介入组，根治组的长期效果明显优于破膜组（P＜0．05），复发率低于破膜组（P＜0．05），结论：膜性布－加综合征患者治疗应首选介入球囊扩张术，对于病变范围大，膜厚和介入治疗后复发的病例，则应用直视下病变隔膜切除术。     

植物粪石性急性小肠梗阻52例分析

总结１９８１－１９９８年３家医院因进食山楂,柿子等所致急性小肠梗阻５２例,方法根据急性小肠梗阻的临床表现,腹部Ｘ线检查,结合病前进食生山楂或柿子等病史,诊断多无困难。结论通过对发病机理的探讨,作者建议对胃肠功能低下,特别是胃大部切除史者,进食生山楂,柿子应视为禁忌。     

A rare cause of gastrointestinal phytobezoars: diospyros lotus

Aim

Diospyros Lotus (??Wild Date Palm of Trabzon or Persimmon??), which has been proven to cause phytobezoars, is a widely consumed fruit in the Black Sea and Northeast Anatolia regions of Turkey. The aim of the present study was to investigate the effects of Diospyros Lotus together with other predisposing factors, on the development of gastrointestinal phytobezoars and to discuss the treatment results in comparison to the literature.

Material and method

The records of 13 patients, who had been admitted to the General Surgery Clinic of Düzce Atatürk State Hospital between August 2008 and August 2011, were retrospectively reviewed. Demographic characteristics, predisposing factors, clinical and radiological findings, diagnostic and therapeutic methods, and the outcomes of the patients were recorded from the patient files. Written informed consent was obtained from each patient for publication of this research article and accompanying images.

Results

All the patients had a history of consuming Diospyros Lotus. Of the patients, 30,7% had a history of previous gastric surgery, 30,7% had diabetes mellitus and 23% had dental implants. None of the patients had hypothyroidism, which is another predisposing factor for phytobezoars. The phytobezoars were located in the stomach alone in 23% of the patients, whereas 15,3% was detected in the jejunum and stomach, 15,3% was detected in the jejunum alone, and 46,1% was detected in the ileum alone. All patients were treated with surgery, and there were no deaths.

Conclusion

Gastric phytobezoars are rare. Preventive measures have particular importance in the management of this condition, which is difficult to treat. For this purpose, excessive consumption of herbal nutrients containing a high amount of indigestible fibers such as Diospyros Lotus should be avoided in patients with a history of gastrointestinal surgery or poor oral and dental health.