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胃大部切除吻合口后间隙内疝的X线诊断(附7例报告)

X-ray Diagnosis of Retroanastomotic Space Hernia After Subtotal Gastrectomy(Report of 7 Cases)
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摘要 胃大部切除(毕氏Ⅱ式手术)吻合口后间隙内疝的报导极少见.本文报告7例并经X 线和手术证实.6例为输出袢型,1例为输入、输出袢型.临床症状为腹痛、腰背痛、呕吐胆汁等.输出袢型内疝有特征性X 线表现,为空肠输出袢位于输入袢之后,输出袢从右上向左下斜行,二者相互交叉,作者称之为“空肠输入、输出袢前后易位交叉征”.作者强调指出,凡有毕氏Ⅱ式手术史的急腹症病人,作胃肠X 线检查时,除注意术后常见并发症外,还要想到本病的可能. Retroanastomotie space hernia af-ter subtotal gastrectomy(Billroth-Ⅰoperation)is seldom reported in lite-rature.This paper reports 7 cases ofthis disease proved roentgenologicallyand surgically.Of them,6 were effe-rent loop type and 1 was afferent-ef-ferent loop type.Clinical symptomasincluded abdominal pain,lumbo-bac-kache and vomiting.The vomitus usua- lly contained bile.The characteristicX-ray sign of efferent loop type was.the efferent loop located behind theafferent loop,and passed down fromright upper to left lower making thetwo loops across each other.It was fi-rst called a cross sign of jejunal affe-rent loop to efferent loop malposition.The authors emphasized that when GIexamination was performed in a pa-tient suffering from acute abdomenwith a history of Billroth-Ⅱ operation,attention should be paid to retroana-stomotic space hernia as well as theusual postoperative complications.
出处 《临床放射学杂志》 CSCD 北大核心 1992年第1期12-14,T003,共4页 Journal of Clinical Radiology
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