避孕环穿出子宫进入腹腔致肠梗阻1例

患者　女 ,46岁。阵发性下腹绞痛伴恶心、呕吐、腹胀 10d ,症状逐渐加重 ,并停止排便排气入院。体查 :脱水貌 ,急性病容 ,腹部膨隆 ,可见肠型和蠕动波。脐周压痛 ,肠鸣音亢进 ,可闻及气过水声。腹透见 4～ 6个气液平 ,经补液、胃肠减压等治疗 12h ,症状无缓解 ,急诊剖腹探查。术中见肠管明显胀气 ,腹腔少量血性渗液 ,距回盲部 2 0cm之回肠约 15cm嵌入由子宫穿出的避孕环 ,形成一闭袢 ,致肠梗阻。避孕环尚有约 1/5在子宫壁内 (附图 )。切断避孕环 ,经肠系膜根部封闭及热敷 ,嵌顿肠管活力恢复正常 ,切开子宫底浆肌层 ,分离取出避孕环。术后恢…     

肠内巨大胆结石致肠梗阻1例

患者　女 ,3岁。因右上腹闷胀 2月余 ,皮肤巩膜黄染 2 0余天以阻塞性黄疸原因待查住院。入院后B超检查显示胆总管明显增粗约 8cm ,下段内有约 10cm× 10cm× 8cm巨大结石影。给予抗菌、解痉、消炎、利胆治疗。入院第3天 ,患者出现中上腹疼痛 ,伴恶心 ,呕吐胃内容物 ,肛门排气停止。体查 :腹胀 ,似可扪及肠型 ,腹部压痛明显且有反跳痛 ,肠鸣亢进 ,有气过水声。腹部平片显示 :小肠梗阻。B超示胆总管较前次检查缩小约 4cm ,结石消失。行急诊剖腹探查术。术中见 :小肠中上段明显充气膨胀 ,于小肠中段腔内有约拳头大小 ,质硬的团块状物阻塞小肠…     

大网膜发育异常并肠梗阻1例

患者　男 ,2 3岁。因持续性腹痛阵发性加剧 2ｄ ,伴呕吐 ,停止排便入院。 2年前曾行右侧隐睾手术。查 :体温 37 5℃ ,脉搏 90次 /ｍｉｎ,呼吸 1 8次 /分 ,血压 96/50ｍｍＨｇ。腹胀 ,全腹压痛 ,无明显反跳痛 ,可扪及拳头大小质软包块 ,位于脐部 ,活动度好 ,移动性浊音阴性 ,肠鸣增强 ,偶闻气过水声。腹透未见游离气体及液平。血红蛋白 1 2 5ｇ/Ｌ ,白细胞 1 0 5× 1 0 9/Ｌ ,中性粒细胞 0 78。诊断 :单纯性肠梗阻。经保守治疗无效 ,于住院第 2ｄ行手术治疗。术中见空回肠被一层半透明 ,少血管的膜状物包裹 ,形成 3个团块 ,团块内多个肠袢 …     

回肠浆膜下阑尾炎致肠梗阻1例

患者男,20岁.因下腹部胀痛,阵发性加剧12h,于2002年1月2日入院.2年前因"肠梗阻"住院保守治愈.     

腹腔内游离隐睾致绞窄性肠梗阻1例

患者男，５４岁。因脐周持续性胀痛阵发性加剧２ｄ入院，体查：体温３８２℃，脉搏１０５次／ｍｉｎ，呼吸２２次／ｍｉｎ，血压１１２／７５ｍｍＨｇ，急性面容。腹饱满，满腹压痛，反跳痛，肌紧张，以右中下腹为甚，肝浊音界存在，移动性浊音可疑，肠鸣音弱。白细胞１...     

自发性空肠浆膜下血肿致肠梗阻1例

患者　男,35岁。因上腹部疼痛10ｄ,伴呕吐3ｄ入院。入院前4个月曾因腹部钝挫伤行剖腹探查,痊愈出院。体查上腹部隆起,右中腹见一10ｃｍ长纵形切口疤痕,上腹偏右扪及一11ｃｍ×9ｃｍ大小包块,质中等,压痛、边界清,不活动。左上腹轻度压痛、反跳痛、腹肌稍紧张,移动性浊音(-),肠鸣音正常。尿淀粉酶256Ｕ(温氏法)。Ｂ超示右上腹一104ｍｍ×80ｍｍ无回声包块,欠规则,边界尚清。诊断:①假性胰腺囊肿?②高位粘连性肠梗阻?入院后经非手术治疗3ｄ,病情无缓解,且于上腹部包块穿刺抽出70ｍｌ暗红色血液。予以剖腹探查。术中见:屈氏韧带下方空肠有一12…     

口服甘露醇肠道准备致急性肠梗阻3例

1 病例报告 例1 女,43岁.因腹痛伴黏液血便1个月余入院.入院后行纤维结肠镜检查,见距肛门口20cm处有肠腔狭窄,病理报告:乙状结肠腺癌Ⅱ级.在常规术前肠道准备时,于当天晨8时口服20%甘露醇500ml,下午4时腹痛加重,腹胀如鼓,急行胃肠减压无效,腹胀进行性加重,血压下降.晚8时急诊手术探查,见乙状结肠狭窄处近端肠管极度扩张,距回盲部105cm处有5cm小肠坏死.行肠切除及乙状结肠造瘘术,术后6h死于脓毒性休克. 例2 女,20岁.因腹泻40d,加重伴腹胀30d入院.入院后行全消化道钡透检查.检查前1日晨8时口服10%甘露醇500ml,晚10时腹痛加重,腹胀如鼓,血压下降至 45/0 mmHg,     

带状疱疹并动力性肠梗阻1例

带状疱疹并动力性肠梗阻１例湖北省长阳土家族自治县人民医院龚志兰，郑平１病例介绍女，１１岁。１９９５年８月９日以不全性肠梗阻收入院。Ｔ３７．３℃，Ｐ９２次／ｍｉｎ，Ｒ２０次／ｍｉｎ，ＢＰ１５／１１ｋＰａ。患儿感恶心、持续性腹部胀痛。偶有阵发性绞痛，腹部...     

胆石性肠梗阻2例

例 1　女 ,80岁。因腹痛、腹胀3d入院。体查 ,一般情况可 ,腹胀明显 ,全腹无确切压痛点 ,未能触及包块 ,肠呜音活跃 ,可闻高调肠呜。腹部透视及立、卧位片见小肠明显扩张 ,中、上腹见多个气、液平面 ,无胆系积气征。入院后行非手术治疗 2 4h无缓解。全麻下行剖腹探查。术中见小肠明显扩张 ,积液、积气 ,距回肠末端60cm处扪及一核桃大硬性包块 ,可活动 ,局部肠壁正常。于肠系膜对侧纵行切开肠壁 ,取出一黑褐色椭圆形色素结石约 3 .5cm× 3cm× 3cm大小 ,行肠减压后间断缝合肠壁 ,关腹。术后诊断 :胆石性肠梗阻。痊愈出院。例 2　女 ,47岁。因…     

Intestinal obstruction caused by infarcted splenic hemangioma with renal vein thrombosis in a newborn: a case report

The spleen in newborns, infants, and children is rarely involved in a variety of pathological processes. These processes may involve an isolated splenic disease or may be a part of a systemic illness. Renal vein thrombosis in infants of diabetic mothers has been reported. We report a case of a newborn with intestinal obstruction caused by an infarcted splenic hemangioma and renal vein thrombosis. To the best of our knowledge, this is the youngest case with both above-mentioned diagnoses and causes of intestinal obstruction in the English medical literature.     

Intestinal obstruction caused by splenic volvulus: Report of a case

Torsion of a wandering spleen is rare, usually presenting as acute abdomen, and is commonly misdiagnosed. In special cases, ultrasonography, arteriography, and additional scintigraphy are extremely valuable in the preoperative diagnostic management. We herein present an unusual case of torsion of a wandering spleen in a 19-year-old female. The presenting symptom was acute gastrointestinal obstruction due to pressure of the enlarged and ptotic spleen in the pelvis. The intestinal obstruction with signs of peritonitis made a laparatomy with removal of the infarcted spleen imperative. After the operation, the patient made a complete recovery.     

Jejunal varices with extra hepatic portal vein obstruction: A case report

Introduction and importanceExtrahepatic portal vein obstruction (EHPVO) with portal hypertension is rare in children. Intestinal varices as new collaterals accompanying portal hypertension are very rare.Presentation of caseWe report an unusual case of a 12-year-old boy with EHPVO with gastrointestinal bleeding from ectopic jejunal varices, without any gastroesophageal varices.DiscussionPortal hypertension is the most common cause of EHPVO. Among various ectopic varices, intestinal varices are found distal to the duodenum and present with complaints of hematochezia, melena, or intraperitoneal bleeding. The diagnosis of the EHPVO is aided by imaging investigations like Doppler ultrasound, computed tomography, or magnetic resonance imaging. A multidisciplinary team including gastroenterologists, interventional radiologists, surgeons, and intensivists is crucial in the management of ectopic varices.ConclusionJejunal varices must be considered in the differential diagnosis of gastrointestinal (GI) hemorrhage in patients with a negative source of bleed on upper and lower GI endoscopy.