胃切除术后的罕见并发症petersen疝

Petersen's Hernia:a Rare Internal Hernia after Gastrectomy and Gastrojejunal Reconstruction

目的探讨petersen疝(petersen's hernia, PH)发病特点及临床表现,以期提高其早期诊疗效果。方法选取2009年～2018年我院收治并手术治疗的16例PH患者,对其临床表现、发病特点及治疗情况进行回顾分析。结果 16例患者中男15例、女1例;平均年龄61.8岁;PH发病距离原胃切除手术时间平均20.5个月;14例患者临床表现主要为腹痛,其中8例同时伴有肛门停止排气排便;1例患者以腹胀为主诉就诊;另1例患者以呕吐咖啡样物为主要临床表现;16例患者中有7例在手术时肠管有坏死。结论 PH是一种较罕见的腹内疝,治疗不及时易发生肠坏死。由于该病没有特异性临床表现,当急腹症患者疑有该病可能时宜早期剖腹探查,以避免肠坏死的发生。

Objective The clinical features of PH were retrospectively analyzed to improve the efficiency of the diagnose and treatment.Methods The clinic features and operational findings of 16 patients suffered from PH were analyzed.Results Mean age of PH was 61.8 years.Fifteen out of 16 were male.The mean interval between the attack of PH and historical gastrectomy was 20.5 months.The clinical presentation ranged from mild to intermittent abdominal pain to smll bowel osbtrucion.Five out of 16 suffered from intestinal necorsis at the time of laparotomy.Conclusion PH was a rare but potentially fatal internal hernia.Preoperative diagnosis of PH was difficult.Since its nonspecific clinical presentation and possible resulted intestinal necrosis,early laparotomy was reasonable.