PDF(Pubmed)
Abstract：
We hereby present a 70-year-old male Ethiopian farmer who presented with clinical manifestations suggestive of acute large bowel obstruction, which had persisted for 3 days. Over the past 3 years, he has experienced three similar recurring episodes, which were alleviated by decompression using a rectal tube. Upon initial examination, the patient displayed signs of cardiopulmonary distress, although no indications of peritonitis were observed. Further evaluation through plain abdominal and chest X-rays revealed findings consistent with sigmoid volvulus, as well as mediastinal shift, elevated diaphragm, and a right-positioned heart. Consequently, a sigmoid resection and an end colostomy were done. The patient showed improvement and was discharged from the hospital on the 14th day following the surgery. It is atypical for an individual to present with acute sigmoid volvulus accompanied by a mediastinal shift resulting from mass action on the hemidiaphragm. Therefore, it may be imperative to involve a pulmonologist in managing this rare situation. By ensuring that the surgical team is well-informed in such circumstances, patients can receive enhanced care and treatment.
摘要：
我们在此介绍一名70岁的埃塞俄比亚男性农民，他的临床表现提示急性大肠梗阻，持续了3天。在过去的3年里,他经历了三次类似的反复发作，通过使用直肠管减压来缓解。经过初步检查,病人表现出心肺窘迫的迹象,尽管没有观察到腹膜炎的迹象。通过腹部和胸部X线平片进一步评估发现与乙状结肠扭转一致，以及纵隔移位，隔膜抬高,和一个正确的心脏。因此,进行了乙状结肠切除术和结肠造口术。患者表现出改善，并在手术后第14天出院。对于一个人来说，出现急性乙状结肠扭转并伴有对半膈肌的肿块作用引起的纵隔移位是非典型的。因此,可能必须让肺科医生参与管理这种罕见的情况。通过确保手术团队在这种情况下消息灵通，病人可以得到加强的护理和治疗。
