PDF(Pubmed)
Abstract：
UNASSIGNED: Bowel obstruction is a mechanical or functional blockade of intestinal contents from evacuation to the adjacent distal bowel or external environment. Cecal volvulus is the twisting of distal ileum, cecum and ascending colon on their mesentery. Transverse colon volvulus is another rare cause of large bowel obstruction even less prevalent than cecal volvulus. Colectomy with decompression stoma is the widely practice of intervention in cecal or transverse colon volvulus.
METHODS: A 45 years-old male patient presented to our center with failure to pass feces and flatus of 5 days duration. He also had crampy abdominal pain, abdominal distention and vomiting of ingested matter. Vital signs were normal except mild tachycardia. He had distended non-tender abdomen, hyperactive bowel sound and hyper-tympanic percussion. However, there was no sign of fluid collection of abdominal or rectal mass. Plain abdominal X-ray showed distended large bowel loops with multiple air fluid levels. Exploratory laparotomy revealed simultaneous cecal and transverse colon clockwise volvulus 270 degrees on their mesentery.
CONCLUSIONS: Mechanical bowel obstruction is major cause of surgical admission in both developed and developing countries. Anatomic and congenital factors play significant role in both transverse colon and cecal volvulus. Endoscopic decompression in the case of cecal and transverse colon volvulus is less probable and not recommended.
CONCLUSIONS: Simultaneous cecal and transverse colon volvulus is an extremely rare occasion where there is no report in the history of literatures to date. Management involves extended right hemicolectomy with proximal diversion and distal mucus fistula.
METHODS: A 45 years-old male patient presented to our center with failure to pass feces and flatus of 5 days duration. He also had crampy abdominal pain, abdominal distention and vomiting of ingested matter. Vital signs were normal except mild tachycardia. He had distended non-tender abdomen, hyperactive bowel sound and hyper-tympanic percussion. However, there was no sign of fluid collection of abdominal or rectal mass. Plain abdominal X-ray showed distended large bowel loops with multiple air fluid levels. Exploratory laparotomy revealed simultaneous cecal and transverse colon clockwise volvulus 270 degrees on their mesentery.
CONCLUSIONS: Mechanical bowel obstruction is major cause of surgical admission in both developed and developing countries. Anatomic and congenital factors play significant role in both transverse colon and cecal volvulus. Endoscopic decompression in the case of cecal and transverse colon volvulus is less probable and not recommended.
CONCLUSIONS: Simultaneous cecal and transverse colon volvulus is an extremely rare occasion where there is no report in the history of literatures to date. Management involves extended right hemicolectomy with proximal diversion and distal mucus fistula.
摘要：
■肠梗阻是肠内容物从排出到邻近的远端肠或外部环境的机械或功能性阻滞。盲肠扭转是回肠远端的扭曲，肠系膜上的盲肠和升结肠。横结肠扭转是大肠梗阻的另一种罕见原因，甚至比盲肠扭转更不普遍。结肠减压造口切除术是盲肠或横结肠扭转的广泛干预措施。
方法：一名45岁的男性患者就诊于我们中心，其粪便和排气未能通过5天。他还有腹痛,腹胀和摄入物质的呕吐。除轻度心动过速外，生命体征正常。他腹部扩张，不柔软，过度活跃的肠鸣音和鼓室高敲击。然而,没有腹部或直肠肿块积液的迹象。腹部X线平片显示大肠环扩张，有多个空气液水平。剖腹探查术显示盲肠和横结肠同时在肠系膜上顺时针扭转270度。
结论：机械性肠梗阻是发达国家和发展中国家手术入院的主要原因。解剖和先天性因素在横结肠和盲肠扭转中起重要作用。在盲肠和横结肠扭转的情况下，内窥镜减压的可能性较小，不建议使用。
结论：同时发生盲肠和横结肠扭转是一种极其罕见的情况，迄今为止在文献史上没有报道。治疗包括扩大的右半结肠切除术，近端转移和远端粘液瘘。
方法：一名45岁的男性患者就诊于我们中心，其粪便和排气未能通过5天。他还有腹痛,腹胀和摄入物质的呕吐。除轻度心动过速外，生命体征正常。他腹部扩张，不柔软，过度活跃的肠鸣音和鼓室高敲击。然而,没有腹部或直肠肿块积液的迹象。腹部X线平片显示大肠环扩张，有多个空气液水平。剖腹探查术显示盲肠和横结肠同时在肠系膜上顺时针扭转270度。
结论：机械性肠梗阻是发达国家和发展中国家手术入院的主要原因。解剖和先天性因素在横结肠和盲肠扭转中起重要作用。在盲肠和横结肠扭转的情况下，内窥镜减压的可能性较小，不建议使用。
结论：同时发生盲肠和横结肠扭转是一种极其罕见的情况，迄今为止在文献史上没有报道。治疗包括扩大的右半结肠切除术，近端转移和远端粘液瘘。
