胃次全切除术后罕见并发症误诊分析  

Analysis of misdiagnostic causes on the rare complications after subtotal gastrectomy

作　　者：郑彦[1] 金慧君[2] 

机构地区：[1]北京大学深圳医院,广东深圳518036 [2]福建漳州市医院

出　　处：《罕少疾病杂志》2004年第4期45-47,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨胃次全切除术后3种罕见并发症的发生及误诊原因.方法对3例胃次全切除术后并发症再次手术患者的临床资料进行回顾性分析.结果男2例,女1例,年龄4 5～72岁,均行毕-Ⅱ式胃次全切除术.胃术后至出现并发症症状分别为20年、1个月和12年,均误诊为腹腔肿瘤.手术证实分别为由输出襻进入宽大吻合口的残胃引起的空肠胃套叠,胃-回肠末端错位吻合,胃窦残留致吻合口穿通性溃疡并吻合口横结肠瘘.3例患者均经手术治愈.随访6个月患者均完全恢复健康.结论本文3例并发症的发生均为医源性因素,与临床误诊及首次手术资料缺如,术后时间较长,对胃术后并发症认识不足等诸多原因有关.Objective To investigate the occurent and misdiagnostic causes of three sorts of rare complications after subtotal gastrectomy. Methods The clinical data of 3 patients with complications after subtotal gastrectomy, which underwent reoperation in our hospital,were analyzed retrospectively. Results Of 3 cases,2 were male and 1 was female.The onset age ranged from 45 to 72. Billroth Ⅱ type were performed in 3 patients. The intervals from the initial operation to the onset of complication were 20 years, 1 month and 12 years, respectively.They were misdiagnosed as abdominal tumors. The operating dianoses were jejunogastric intussusception as a result of the efferent loop enters into gastric stump through the broad anastomotic stoma,wrong gastroileumectorny.The retained antrum was responsible for postoperative penetrating ulcer in the stoma and gastrotransvere colonic fistula. The health conditions of the patients recovered completely during the follow-up of 6 months. Conclusion Iatrogenic factors were responsible for the occurent of complications in all 3 cases, such as the first procedure data of the patients was absence, postoperating time was long and the recognition of rare complications was scarcity.

关 键 词：胃次全切除术 并发症 误诊 

分 类 号：R656.61[医药卫生—外科学]