迷走神经切断术治疗十二指肠闭锁伴严重胃出血1例

dnshnmh Srm Pub Date : 2020-06-01 DOI:10.52547/sjrm.5.1.48
S. Seyedi, Seyed Arsalan Seyedi, M. Samet, S. Mortazavi, Mohammad Reza Nateghi (MD, MPH), Maryam Sanaye Naderi
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引用次数: 0

摘要

去手术室。在手术室里,由于严重出血和低血压,麻醉师竭尽全力为婴儿插管,随后,婴儿接受了胃切开术,并清除了血栓。粘膜表面渗出了血。然后,进行十二指肠造口术,在出血进入胃后继续进行,因此在这种情况下,提出了几种解决方案,如全胃切除术、起搏和迷走神经切断术。婴儿接受了迷走神经干前后切开术。迷走神经切断术后胃出血立即得到控制。因为迷走神经切断术会导致幽门收缩,所以也要对婴儿进行胃空肠造口术。婴儿在新生儿重症监护室度过一段时间后出院,总体状况良好,没有任何并发症。结论:十二指肠闭锁并发严重胃肠道出血的情况十分罕见。在这种情况下,可以考虑并进行胃切除术,这将在未来带来许多问题。在成年人中,具有血管收缩机制的迷走神经切断术用于控制胃出血。然而,目前尚无控制婴儿胃肠道出血的病例报告。在这种情况下,尽管有特殊的技术细节,但首次进行了新生儿迷走神经切断术,这也带来了良好的治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A rare case of duodenal atresia with severe gastric bleeding, treated by vagotomy
to the operating room. In the operating room, due to severe bleeding and hypotension, with great effort by the anesthesiologist, the infant was intubated and subsequently, the infant underwent gastrotomy and blood clots were removed. There was oozing of blood from the mucosal surface. Then, duodenodenodenostomy surgery was performed, which continued after bleeding into the stomach, so in these conditions, several solutions such as total gastrectomy, pacing, and vagotomy were proposed. The infant underwent anterior-posterior truncal vagotomy. Gastric bleeding was controlled immediately after vagotomy. Because vagotomy can cause the pyloric constriction, gastrojejunostomy is also performed on the baby. The infant was discharged in good general condition without any complications after spending time in the neonatal intensive care unit. Conclusion: Severe gastrointestinal bleeding is a very rare occurrence in duodenal atresia. In this situation, a gastrectomy can be considered and performed, which will be associated with many problems in the future. In adults, a vagotomy with a vascular contraction mechanism is used to control gastric bleeding. However, no case has been reported in the control of gastrointestinal bleeding in infants. In this case, for the first time, neonatal vagotomy was performed despite special technical subtleties, which was also accompanied by excellent therapeutic results.
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