十二指肠旁疝9例诊治报告

Diagnosis and treatment of paraduodenal hernia:a report of 9 cases

[目的]总结十二指肠旁疝(PDH)的诊治经验。[方法]回顾1986年～2008年经外科手术治疗的9例PDH患者的临床资料,对其诊治经过进行分析。[结果]本组患者左侧PDH(Landzert隐窝)7例,右侧PDH(Waldeyer隐窝)2例。2例平素无任何临床症状;5例患者在饱食后、4例患者在剧烈运动或突然改变体位后出现上腹剧烈疼痛。腹部X线检查提示9例为完全或不完全性肠梗阻。2例行增强CT显示,左上腹胰腺和胃之间有扩张的囊性空肠袢。9例均行手术治疗,术后7～13 d痊愈。[结论]PDH术前诊断困难,积极手术探查是正确诊断和治疗成功的关键。

[Objective] To summarize the clinical experience on the diagnosis and treatment for paraduodenal hernia（PDH）.[Methods] The clinical data of 9 cases with PDH surgically treated from 1986 to 2008 were retrospectively analyzed.[Results] The average age of the patients was 42.There were 7 cases with left PDH（Landzert＇s hernia） and 2 cases with right PDH（Waldeyer＇s hernia）.Two patients usually had no symptoms,while acute abdominal pain after full food in 5 cases and after vigorous movement in 4 cases respectively.X-way revealed complete or incomplete intestinal obstruction in 9 cases,enhanced CT scan revealed dilated systic jejunal loop between the pancreas and the stomach in 2 cases.All the patients were undergone exploratory laparotomy,and the hospital stay ranged from 7 to 13 days.[Conclusion] PDH is difficult to diagnosis before operation,it is the key to perform exploratory operation for suspicious PDH actively.