Objective To study the etiology, pathogenesis, and diagnosis of small bowel volvulus in adults.
Method The clinical data of 43 cases of small bowel volvulus admitted to HassanⅡHospital of Settat from October 2009 to October 2012 were analyzed retrospectively.
Results There were 11 cases of spontaneous small bowel volvulus.
There were 32 cases of secondary small bowel volvulus, of which 19 cases due to postoperative abdominal adhesions. Clinical manifestation:early persistent severe abdominal pain was in 40 cases, frequent vomiting was in 29 cases, intestinal
pattern or abdominal mass was in 28 cases. All 43 patients were received surgery, 22 (51.2%) cases were diagnosed by preoperative ultrasonography, small bowel necrosis was found in 16 cases during operation, 37 (86.0%) patients were cured and 6 (14.0%) patients died.
Conclusions Secondary small bowel volvulus is main small bowel volvulus, post-
operative abdominal adhesion is major causes of small bowel volvulus, the value of abdominal X-ray in diagnosing is limited. However, ultrasonography and CT are helpful in diagnosing these diseases. Small bowel volvulus and intestinal obstruction can reinforce each other. Early small bowel volvulus is characterized by clinical conditions such as severe abdominal pain, early vomiting signs, and signs not matching the symptoms. Acute onset and rapid progression are the features of small bowel volvulus, surgery should be intervened in early stage.
Citation:
LI Xinping,Dubaba Hassan,ZOU Jianhua,LIU Wenfang.. Clinical Analysis of Pathogenesis and Early Diagnosis of Small Bowel Volvulus (Report of 43 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(11): 1279-1283. doi:
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Akcan A, Akyildiz H, Artis T, et al. Feasibility of single-stage resection and primary anastomosis in patients with acute noncomplicated sigmoid volvulus[J]. Am J Surg, 2007, 193(4):421-426.
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雷尚通, 孙凯, 吴承堂. 成人先天性肠旋转不良并肠扭转的诊治[J]. 中华胃肠外科杂志, 2011, 14(1):51.
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陶云年, 张文奇, 王善军, 等. 腹内疝伴肠扭转的螺旋CT诊断[J]. 医学影像学杂志, 2012, 22(1):102-105.
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徐崇松, 张洺, 丁丽娟. 老年人小肠扭转的诊断和治疗[J]. 中国实用医刊, 2011, 38(10):74-75.
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邱云峰, 瞿敏, 任重, 等. 48例乙状结肠扭转的病因诊断及治疗[J/CD]. 中华普外科手术学杂志:电子版, 2011, 5(4):435-440.
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贾树范, 王振峰, 张波, 等. 成人小肠扭转26例临床分析[J]. 山东医药, 2010, 50(27):88-89.
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曾祥芹, 胡道予, 庞颖, 等. MSCTA诊断肠扭转[J]. 放射学实践, 2011, 26(10):1075-1078.
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Patino MO, Munden MM. Utility of the sonographic whirlpool sign in diagnosing midgut volvulus in patients with atypical clinicalpresentations[J]. J Ultrasound Med, 2004, 23(3):397-401.
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文晓蓉, 黄景, 陈扬, 等. 彩色多普勒超声诊断罕见肠扭转2例[J]. 西部医学, 2010, 22(10):F0003.
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张号绒, 何静波, 周崇高, 等. 彩色多普勒超声对儿童肠扭转的诊断价值[J]. 临床小儿外科杂志, 2012, 11(1):34-35.
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朱建兵, 陆苏华, 陈光强, 等. 多排螺旋CT血管成像诊断肠扭转[J]. 中华普通外科杂志, 2010, 25(4):334-335.
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毛芸, 李咏梅, 罗天友. 肠系膜血管“漩涡征”在腹部CT影像中的诊断价值[C]. 杭州:第三届中国放射青年医师学术论坛论文集, 2009:202-204.
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鲁琪. 乙状结肠扭转的临床诊治[J]. 临床和实验医学杂志, 2011, 10(4):278, 281.
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- 1. 吴阶平, 裘法祖. 黄家驷外科学(中册)[M]. 第7版. 北京:人民卫生出版社, 2010:1077-1078.
- 2. Akcan A, Akyildiz H, Artis T, et al. Feasibility of single-stage resection and primary anastomosis in patients with acute noncomplicated sigmoid volvulus[J]. Am J Surg, 2007, 193(4):421-426.
- 3. 雷尚通, 孙凯, 吴承堂. 成人先天性肠旋转不良并肠扭转的诊治[J]. 中华胃肠外科杂志, 2011, 14(1):51.
- 4. 罗中尧, 贾忠, 金慧成, 等. 少见病因引起的肠梗阻102例诊治体会[J]. 中华胃肠外科杂志, 2003, 6(4):266.
- 5. 朱代华, 张兴明. 成人小肠扭转早期诊断的探讨[J]. 中国实用外科杂志, 2000, 20(4):229-230.
- 6. 陶云年, 张文奇, 王善军, 等. 腹内疝伴肠扭转的螺旋CT诊断[J]. 医学影像学杂志, 2012, 22(1):102-105.
- 7. 徐崇松, 张洺, 丁丽娟. 老年人小肠扭转的诊断和治疗[J]. 中国实用医刊, 2011, 38(10):74-75.
- 8. 校宏兵, 谭江平, 卢少毅, 等. 成人急性小肠扭转 64例分析[J]. 中华胃肠外科杂志, 2001, 4(2):124-125.
- 9. 邱云峰, 瞿敏, 任重, 等. 48例乙状结肠扭转的病因诊断及治疗[J/CD]. 中华普外科手术学杂志:电子版, 2011, 5(4):435-440.
- 10. 贾树范, 王振峰, 张波, 等. 成人小肠扭转26例临床分析[J]. 山东医药, 2010, 50(27):88-89.
- 11. 曾祥芹, 胡道予, 庞颖, 等. MSCTA诊断肠扭转[J]. 放射学实践, 2011, 26(10):1075-1078.
- 12. Patino MO, Munden MM. Utility of the sonographic whirlpool sign in diagnosing midgut volvulus in patients with atypical clinicalpresentations[J]. J Ultrasound Med, 2004, 23(3):397-401.
- 13. 文晓蓉, 黄景, 陈扬, 等. 彩色多普勒超声诊断罕见肠扭转2例[J]. 西部医学, 2010, 22(10):F0003.
- 14. 张号绒, 何静波, 周崇高, 等. 彩色多普勒超声对儿童肠扭转的诊断价值[J]. 临床小儿外科杂志, 2012, 11(1):34-35.
- 15. 朱建兵, 陆苏华, 陈光强, 等. 多排螺旋CT血管成像诊断肠扭转[J]. 中华普通外科杂志, 2010, 25(4):334-335.
- 16. 毛芸, 李咏梅, 罗天友. 肠系膜血管“漩涡征”在腹部CT影像中的诊断价值[C]. 杭州:第三届中国放射青年医师学术论坛论文集, 2009:202-204.
- 17. 鲁琪. 乙状结肠扭转的临床诊治[J]. 临床和实验医学杂志, 2011, 10(4):278, 281.