十二指肠先天性狭窄并肠系膜上动脉压迫综合征1例的诊治体会

Experience on treating a patient with congenital stenosis of duodenum combined with superior mesenteric artery compression syndrome

目的:探讨十二指肠先天性狭窄并肠系膜上动脉压迫综合征(SMACS)的治疗方法。方法:对1例成人十二指肠先天性狭窄并SMACS患者的临床资料进行回顾性分析。结果:患者因"间断恶心、呕吐30年,加重6 d"入我院消化内科。胃镜示,十二指肠降部中下段管腔狭窄(先天性可能)。转入我科进一步治疗。术中见肠系膜上动脉右侧十二指肠扩张显著,术中补充诊断:肠系膜上动脉压迫综合征,遂行十二指肠狭窄隔膜切除并十二指肠空肠吻合术。术后患者恢复顺利。结论:对十二指肠先天性狭窄合并SMACS的治疗,应采取狭窄隔膜切除并十二指肠空肠吻合术,而仅采用其中之一的手术方式是不可取的。

Objective： To investigate the treatment of congenital stenosis of duodenum combined with superior mesenteric artery compression syndrome （ SMACS ） . Methods： We retrospectively analyzed the clinical data of 1 case of adult congenital stenosis of duodenum combined with SMACS. Results： The patient was in Department of Internal Medicine for “intermittent nausea, vomiting for thirty years, aggravated for six days”. Gastroscopy showed： the distal of descending part of the duodenum stenosis （ maybe congenital ） . Then this patient was transferred to our department for further treatment. The duodenum right to superior mesenteric artery was be found dilatation intraoperation, so SMACS was supplementary diagnosed. We performed duodenal septum resection and duodenum jejunum anastomosis. The postoperative course was smooth. Conclusion： The appropriate treatment should be performed duodenal septum resection and duodenum jejunum anastomosis for congenital stenosis of duodenum combine with SMACS, instead of using only one operation mode.