宫颈癌术后并发间位结肠综合征一例报道并文献复习

Chilaiditi Syndrome after Cervical Cancer Surgery:A Case Report and Literature Review

间位结肠综合征(Chilaiditi综合征)在1865年由Cantini首次提出。如果仅表现为无症状的影像学改变,则称为Chilaiditi征;如果有症状,则称为Chilaiditi综合征。Chilaiditi征的发病率极低,仅为0.025%~0.28%,多见于男性及老年患者。其诊断主要依靠X线、电子计算机断层扫描(CT)及超声。Chilaiditi综合征易被误诊为肠梗阻、气腹等,临床中应注意鉴别,避免误诊误治。吉林大学第二医院于2018年10月16日收治1例66岁女性患者,该患者以宫颈癌入院,入院后行开腹广泛全子宫切除术+双侧附件切除术+盆腔淋巴结清扫术,术后第2天并发Chilaiditi综合征致呼吸窘迫及血氧饱和度持续性降低,确诊Chilaiditi综合征后给予经肛门肠梗阻导管置入术等保守对症治疗,积极控制肺部感染,纠正低氧血症。本文针对该病例资料报道进行相关文献复习。

Interposition colon syndrome (Chilaiditi syndrome) was first proposed by Cantini in 1865. If there are only the imaging changes but no clinical symptoms, it is known as Chilaiditi sign. If there are symptoms, it is known as Chilaiditi syndrome. The incidence of Chilaiditi sign is extremely low, only 0.025%-0.28%, which is more common in male and elderly patients. The diagnosis of Chilaiditi sign mainly depends on X-ray, CT and ultrasound. Chilaiditi syndrome is easy to be misdiagnosed as intestinal obstruction, pneumoperitoneum, etc., and should be differentiated in clinical practice to avoid misdiagnosis and mistreatment. A 66- year-old female patient admitted to our hospital on October 16, 2018 was hospitalized with cervical cancer. After admission, the patient underwent extensive transabdominal hysterectomy + bilateral adnexectomy + bilateral pelvic lymph node dissection. The patient was complicated with Chilaiditi syndrome on the 2nd day after surgery, which led to respiratory distress and continuous decrease in blood oxygen saturation. After the diagnosis of Chilaiditi syndrome, the patients were given conservative symptomatic treatment, such as transanal intestinal obstruction catheterization, active control of pulmonary infection, and correction of hypoxemia. This paper reported the case and reviewed relevant literature.