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中华结直肠疾病电子杂志 ›› 2020, Vol. 09 ›› Issue (01) : 85 -87. doi: 10.3877/cma.j.issn.2095-3224.2020.01.017

所属专题: 经典病例 文献

病例报道

胃空肠Roux-en-Y吻合术后吻合口-横结肠瘘一例
刘书豪1, 张宪祥1, 卢云2,()   
  1. 1. 266000 青岛大学附属医院胃肠外科
    2. 266000 青岛大学附属医院胃肠外科;266003 山东省青岛大学附属医院数字医学与计算机辅助手术重点实验室
  • 收稿日期:2019-05-28 出版日期:2020-02-20
  • 通信作者: 卢云
  • 基金资助:
    国家自然科学基金(No.81802473)

A case of anastomotic-transverse colon fistula after Roux-en-Y gastrojejunostomy

Shuhao Liu1, Xianxiang Zhang1, Yun Lu2,()   

  1. 1. Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao 266000, China
    2. Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao 266000, China;Key Laboratory of Digital Medicine and Computer-assisted Surgery, Affiliated Hospital of Qingdao University, Qingdao 266003, China
  • Received:2019-05-28 Published:2020-02-20
  • Corresponding author: Yun Lu
引用本文:

刘书豪, 张宪祥, 卢云. 胃空肠Roux-en-Y吻合术后吻合口-横结肠瘘一例[J/OL]. 中华结直肠疾病电子杂志, 2020, 09(01): 85-87.

Shuhao Liu, Xianxiang Zhang, Yun Lu. A case of anastomotic-transverse colon fistula after Roux-en-Y gastrojejunostomy[J/OL]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2020, 09(01): 85-87.

胃空肠Roux-en-Y吻合术后发生吻合口-横结肠瘘非常罕见,患者早期症状不明显且容易漏诊和误诊,典型三联征包括腹泻、体重减轻、粪性呕吐或粪性嗳气,确诊方式主要依据消化道造影和胃肠镜检查,对于明确诊断的患者需在营养状况改善的前提下尽早行手术治疗。本例患者通过行上消化造影及胃镜检查确诊该疾病,经过积极的术前准备和一期手术治疗后,症状明显改善。现将本中心对该疾病的诊疗过程及治疗体会报道如下。

Anastomotic-transverse colon fistula after Roux-en-Y gastrojejunal anastomosis is very rare. Early symptoms of patients are not obvious and easy to be missed and misdiagnosed. Typical triad symptoms include diarrhea, weight loss, fecal vomiting or fecal belching. According to digestive tract radiography and gastrointestinal endoscopy, patients with definite diagnosis should be treated as soon as possible under the premise of improving nutritional status. In this patient, the disease was diagnosed by upper gastrointestinal radiography and gastroscopy. After active preoperative preparation and one-stage surgery, the symptoms were significantly improved. The Center′s diagnosis and treatment process and treatment experience for the disease are reported as follows.

图5 切除的标本(A:胃;B:空肠;C:横结肠)
[1]
D′Amata G, Rahili A, Karimdjee-Soilihi B, et al. Gastrojejunocolic fistula after gastric surgery for duodenal ulcer: case report [J]. G Chir, 2006, 27(10): 360-362.
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Czerny V. Zur Behandlung der Fissure und des Vorfalls des Mastdarms [J]. Beitr Klin, Chir, 1903, 37: 765-769.
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