背景:盲肠扭转(CV)是一种罕见的肠梗阻原因。然而,几十年来,病例数量稳步上升。发展CV的患者的人口统计学特征已经改变为更老的人群。我们进行了回顾性审查,以确定发病率,人口统计概况,管理,以及过去九年来我们机构中CV患者的结局。方法对2011年1月1日至2020年3月31日在伍斯特郡急症医院NHSTrust诊断为CV的所有患者进行回顾性审核。患者接受任何其他类型的扭转,如乙状结肠扭转,小肠扭转,胃扭转被排除。对国际疾病分类下收治的所有病人的电子病历进行系统的检索,第十修订代码K562:在研究持续时间内进行肠扭转。总共有1,019名患者。排除所有没有CV或盲肠的患者后,我们纳入了最终分析的36例患者.结果我们的大多数患者是女性(78%),中位年龄为76岁。大多数(86%)患有至少一种医学合并症,36%的人曾进行过腹部手术。94%的患者以腹痛为主要主诉。所有患者均接受了计算机断层扫描(CT)扫描以确认其诊断。我们的大多数患者(84%)接受了手术。开放右半结肠切除术是最常见的手术(87%)。在六名没有接受手术的患者中,三人对肠道休息和鼻胃管减压有反应;一名患者成功接受了结肠镜减压。相比之下,两个病人,不幸的是,去世了.平均住院时间为9天,30天死亡率为3%。结论CV仍然是肠梗阻的罕见原因。我们的大多数病人都很老,脆弱,有医疗合并症。超过三分之一的患者曾接受过腹部手术。早期CT扫描后进行右半结肠切除术与低死亡率相关。
Background Caecal volvulus (CV) is a rare cause of bowel obstruction. However, there has been a steady rise in the number of cases over the decades. The demographic profile of patients developing CV has changed to a much older population. We conducted a retrospective review to determine the incidence, demographic profile, management, and outcomes of CV patients in our institution during the last nine years. Methodology A retrospective audit of all patients diagnosed with CV at Worcestershire Acute Hospitals NHS Trust between 01 January 2011 and 31 March 2020 was performed. Patients admitted with any other type of volvuli such as sigmoid volvulus, small bowel volvulus, and gastric volvulus were excluded. A systematic search of the electronic medical records for all patients admitted under the International Classification of Diseases, Tenth Revision code K562: volvulus was performed for the study duration. It yielded a total of 1,019 patients. After excluding all patients who did not have either a CV or caecal bascule, we included 36 patients in the final analysis. Results Most of our patients were females (78%) with a median age was 76 years. The majority (86%) had at least one medical comorbidity, and 36% had a previous abdominal operation. Abdominal pain was the main complaint in 94% of patients. All patients had undergone a computed tomography (CT) scan to confirm their diagnosis. Most of our patients (84%) underwent surgery. Open right hemicolectomy was the most commonly performed operation (87%). Out of the six patients who did not undergo surgery, three responded to bowel rest and nasogastric tube decompression; one patient underwent successful colonoscopic decompression. In contrast, two patients, unfortunately, passed away. The median length of hospital stay was nine days, with a 30-day mortality of 3%. Conclusions CV remains a rare cause of bowel obstruction. Most of our patients were old, frail, and had medical comorbidities. More than one-third of patients had undergone previous abdominal surgery. Early CT scan followed by right hemicolectomy was associated with low mortality.