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.     

异位门静脉致肠梗阻1例

患者男,42岁.上腹胀痛不适1年,加重伴呕吐3个月入院.疼痛多为进食后10～20min出现,持续0.5～2h,与体位无关.进食牛奶、稀饭较进食固体食物的疼痛轻.口服吗叮啉及法莫替丁治疗无效.近3个月来疼痛加重.每天至少呕吐1次,严重时自己催吐.只能饮少许牛奶及菜汤.体查:消瘦,轻度恶病质.上腹部偶可见胃型及蠕动波.上消化道钡餐透视显示十二指肠降部狭窄、球部显著扩张.胃镜检查见十二指肠降部狭窄,粘膜正常.     

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…     

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...     

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…     

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...     

自发性肾包膜下血肿一例

自发性肾包膜下血肿临床少见,容易误诊和延误治疗。我们收治１例,报道如下。 患者女性,２７岁,农民。因“反复腰痛 １５ ｄ”入院。１５ｄ前患者无明显诱因出现右侧持续性腰部钝痛,活动时加重,休息后可自行缓解。当地Ｂ超示“右肾占位病变,左肾正常”。ＣＴ示“双肾包膜下积血”。血常规、小便常规、肝功能、肾功能均无异常。因右侧腰痛加重,并向肩背部放射,抗炎治疗无效,为进一步诊治入我院。否认外伤、挤压伤等病史,无遗传病史,月经史无异常。查体 ＢＰ １１２／７５ｍｍＨｇ,一般情况尚可,心肺无异常,腹软,肝脾未们及,…     

胃空肠结肠瘘1例

患者　男 ,30岁。 2 0 0 2年 7月 4日入我院。 6年前因上消化道大出血在当地医院急诊行幽门窦旷置大部切除术(Ｂａｎｃｒｏｆｔ术 ) ,术后恢复顺利。术后第 3年出现腹泻 ,每天 3次左右 ,为稀便 ,量不多 ,含不消化食物 ,多次作钡灌肠检查未发现明显异常 ,按结肠炎治疗 ,无效。 1年前腹泻加重 ,每天 5～ 8次 ,为水样便 ,仍含不消化食物 ,钡灌肠检查未发现异常 ,仍按结肠炎治疗 ,无效 ,逐渐消瘦 ,并出现双下肢水肿。体检 :血压 95/ 55ｍｍＨｇ ,消瘦 ,贫血貌 ,肠鸣音活跃 ,双侧踝部、胫前可凹性水肿。血红蛋白 82 .5ｇ/Ｌ ,血清白蛋白 /球蛋白…     

空肠多发性憩室并乳糜性腹膜炎1例

患者　男 ,5 6岁。因反复脐周及右下腹痛 4年 ,加重 2ｄ入院。体查 :体温 37 2℃。急性痛苦病容 ,心肺正常 ,腹部稍膨隆 ,无胃肠型及蠕动波 ,满腹压痛 ,肌紧张 ,反跳痛 ,尤以右下腹为甚 ,移动性浊音 ( ) ,肠鸣音减弱。血红蛋白 115ｇ Ｌ ,白细胞 13 5× 10 9 Ｌ ,中性 0 78。腹透示右下腹部肠腔内胀气 ,可见 2个浅液平面。诊断 :急性阑尾炎穿孔并弥漫性腹膜炎。行剖腹探查术 ,术中见腹内有乳白色腹水 5 0 0ｍｌ左右。距屈氏韧带 8ｃｍ以下的空肠 ,可见 2 0多个囊性肿块 ,大的约3ｃｍ× 3ｃｍ ,小的 1ｃｍ× 1ｃｍ左右。肠管周围可见皂化痕…     

Life-threatening airway obstruction caused by a retropharyngeal haematoma

We present the case of a 68-year-old woman who had a large cervicomediastinal haematoma that caused life-threatening airway obstruction. Retropharyngeal haematoma may occur in any age group and following a variety of causes. Retropharyngeal haematomas must be considered as a cause of airway obstruction following common injuries such as blunt cervical trauma or internal jugular vein cannulation. A high index of suspicion and early lateral neck X-ray is essential for safe management of this rare but potentially life-threatening injury.     

Laparoscopic management for spontaneous jejunal perforation caused by nonspecific ulcer: A case report

IntroductionNonspecific small bowel ulcers are rare and there have been limited reports. We applied laparoscopic surgery successfully for the perforation caused by this disease of jejunum.Presentation of case: A 70-year-old man visited to our hospital with complaint of abdominal pain and fever. He was diagnosed abdominal peritonitis with findings of intraperitoneal gas and fluid. Emergency laparoscopic surgery was performed. A perforation 5 mm in diameter was recognized in jejunum opposite side of mesentery. Partial resection of jejunum with end-to-end anastomosis and peritoneal lavage were performed. Pathologically, an ulcer was recognized around the blowout perforation without specific inflammation. He was discharged uneventfully 12 days after surgery.ConclusionLaparoscopic surgery has diagnostic and therapeutic advantages because of its lower invasion with a good operation view, and in case of the small bowel, it is easy to shift extra-corporeal maneuver.     

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.     

Management of a jejunal obstruction caused by the migration of a laparoscopic adjustable gastric banding. A case report

IntroductionWe present a rare case of jejunal obstruction due to the migration of a laparoscopic adjustable gastric band (LAGB) that occurred 10 years after surgery and was successfully treated by laparoscopy. This report is compliant with the SCARE guidelines.Presentation of caseA 42-year-old woman who underwent LAGB for morbid obesity 10 years ago was admitted with a small bowel obstruction due to the migration of a LAGB in the proximal small bowel. An attempt to endoscopic removal was unsuccessful and resulted in a laparoscopic extraction of the band. The post-operative course was uneventful.DiscussionFormerly, LAGB was considered the safest technique in bariatric surgery. However, the rate of complication increases in long-term studies. When the IGM of the band is diagnosed, removal is the only issue. Small bowel obstruction caused by a migrated band appears to be a rare complication following IGM, and the only therapeutic option is surgery because an endoscopic procedure is not reliable. Furthermore, LAGB appears to be a less effective technique for weight loss than the sleeve gastrectomy and the gastric bypass.ConclusionSmall bowel obstruction caused by LAGB migration is a rare but serious complication following IGM. In such cases, endoscopy has to be avoided because of the risk of jejunal disruption. The only way to treat it properly is surgery. This type of late complication reinforces the interest in the techniques currently used in bariatric surgery such as sleeve gastrectomy and gastric bypass, providing also a better weight loss than the LAGB.