胃空肠Roux-en-Y吻合术后吻合口-横结肠瘘一例

A case of anastomotic-transverse colon fistula after Roux-en-Y gastrojejunostomy

胃空肠Roux-en-Y吻合术后发生吻合口-横结肠瘘非常罕见,患者早期症状不明显且容易漏诊和误诊,典型三联征包括腹泻、体重减轻、粪性呕吐或粪性嗳气,确诊方式主要依据消化道造影和胃肠镜检查,对于明确诊断的患者需在营养状况改善的前提下尽早行手术治疗。本例患者通过行上消化造影及胃镜检查确诊该疾病,经过积极的术前准备和一期手术治疗后,症状明显改善。现将本中心对该疾病的诊疗过程及治疗体会报道如下。

Anastomotic-transverse colon fistula after Roux-en-Y gastrojejunal anastomosis is very rare.Early symptoms of patients are not obvious and easy to be missed and misdiagnosed.Typical triad symptoms include diarrhea,weight loss,fecal vomiting or fecal belching.According to digestive tract radiography and gastrointestinal endoscopy,patients with definite diagnosis should be treated as soon as possible under the premise of improving nutritional status.In this patient,the disease was diagnosed by upper gastrointestinal radiography and gastroscopy.After active preoperative preparation and one-stage surgery,the symptoms were significantly improved.The Center′s diagnosis and treatment process and treatment experience for the disease are reported as follows.