一名中年患者门静脉海绵状变性的中肠下垂:病例报告

Obada Nayef Al-leimon, Abdallah Hamdan, Ahmad Al-leimon, Mohammad Rashdan
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引用次数: 0

摘要

导言:中肠翻卷和门静脉海绵样变(CTPV)是成人中罕见的疾病。先天性肠道异常可导致成人中肠翻卷,这是一种危及生命的肠梗阻,症状不特异,诊断困难。病例介绍:我们报告了一例 46 岁男性患者的病例,他出现剧烈的中央腹痛、呕吐和便秘三天,显示有肠梗阻。无造影剂 CT 显示中肠旋转不良,并伴有因肠管卷曲导致的小肠梗阻。术后造影剂 CT 显示门静脉存在多条袢,提示为空腔变。手术过程在手术过程中,术中发现了一条拉德带、右上腹的DJ交界处和一段长约30厘米、位于DJ交界处远端50厘米处的坏疽肠段。手术方法包括拉德氏手术、裂解肠带、切除坏疽部分并进行侧对侧吻合,以及阑尾切除术。结论:这是一个独特的病例研究,展示了一名成人的两种罕见病症--中肠倒卷和门静脉海绵样变。这两种疾病在成人中很少见,需要采用多学科方法进行诊断和管理,强调早期发现和干预,以预防严重并发症。本病例报告对这些病症提出了新的见解,强调了迅速采取行动的必要性,可能是医学文献中记录的首个病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Midgut volvulus with cavernous transformation of the portal vein in a middle-aged patient: a case report
Introduction: midgut volvulus and cavernous transformation of the portal vein (CTPV) are rare conditions in adults. congenital anomaly of the intestines that can cause midgut volvulus, a life-threatening intestinal obstruction, in adults with nonspecific symptoms and diagnostic challenges. Case Presentation: We report a case of A 46-year-old male who had severe central abdominal pain, vomiting, and obstipation for three days, indicating intestinal obstruction. The CT without contrast revealed midgut malrotation with small bowel obstruction due to volvulus. The post-operative CT with contrast findings reveals the presence of multiple collaterals of the portal vein, which is suggestive of cavernous transformation. The procedure: During the procedure, intraoperative findings revealed a Ladd band, the DJ junction in the right upper quadrant, and a gangrenous bowel segment measuring approximately 30 centimeters in length and located 50 centimeters distal to the DJ junction. The surgical approach included a Ladd's procedure, lysis of the band, resection of the gangrenous section, with a side-to-side anastomosis, and an appendectomy. Conclusion: A unique case study presents an adult with two uncommon conditions—midgut volvulus and cavernous transformation of the portal vein. Their occurrence is rarely seen in adults, requires a multidisciplinary approach for diagnosis and management, emphasizing early detection and intervention to prevent severe complications. This case report contributes novel insights to these conditions and underscores the need for swift action, potentially marking the first instance documented in medical literature
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