卵巢肿瘤蒂扭转致肠梗阻临床分析并文献回顾

目的 分析卵巢肿瘤蒂扭转致肠梗阻的临床特点及诊治情况.方法 回顾性分析2000年1月至2011年2月我院收治的5例卵巢肿瘤蒂扭转致肠梗阻病例,分析其年龄、病史、临床表现、体格检查、辅助检查、诊断及治疗情况,并对国内相关文献报道行回顾性分析.结果 5例患者年龄68 ～ 77岁.4例有慢性腹痛.3例有便秘习惯.4例首诊外科；1例首诊妇科.4例首诊外科患者诊断肠梗阻,1例急诊手术；3例行保守治疗未愈,其中1例盆腔超声发现卵巢肿瘤转妇科手术,余未发现明确病因行剖腹探查.1例首诊妇科患者诊断卵巢肿瘤蒂扭转、肠梗阻,急诊手术.术中证实5例均为一侧卵巢肿瘤蒂扭转,直径8～20 cm,嵌入子宫直肠窝,蒂部扭转360.～720..术后肠梗阻症状解除.结论 老年女性患者出现肠梗阻症状前有隐匿性腹痛病史,未查到明确病因时应考虑有卵巢肿瘤的可能性.

The torsion of ovarian tumors presenting as bowel obstruction and literature review

Objective To analyze the clinic characteristics of the torsion of ovarian tumors presenting as bowel obstruction. Methods Five cases were retrospectively evaluated from Jan 2000 to Feb 2011, including age, history, clinic symptoms, physical and laboratorial examinations, diagnosis and treatment. Similar cases were searched in National Knowledge Infrastructure. Results Patients were 68-77 years old. 3 cases had habitual constipation. 4 eases suffered from lower abdominal pain before administration, presenting with the symptoms of obstruction, and went to see the surgeons. Of the 4 cases who went to see the surgeons, 1 patient received emergency operation. Expectant treatments were performed in other 3 patients ： 1 case received ultrasonic scanning and other 2 cases was diagnosed with laparotomy. The other one was diagnosed ovarian torsion and bowel obstruction by a gynecologist and received emergency operation. Of all the 5 cases, operation demonstrated the torsion of adnexal masses situated Douglas pouch with a size of 8-20 cm and an angle of 360-720 degree. Bowel obstruction was relieved after oeration. Conclusion The bowel obstruction in senile women may be caused by ovarian tumors.