毕Ⅱ式胃大部分切除术后急性逆行性胃套叠诊断及治疗  

Diagnosis and treatment in patients with acute retrograde jejunogastric intussusception after Billroth Ⅱ gastrectomy

作　　者：俞建雄[1] 谭海燕[1] 马书进[1] 赫杰[1] 童仕伦[1] 

机构地区：[1]武汉大学人民医院胃肠外科,武汉430060

出　　处：《临床急诊杂志》2016年第1期33-37,共5页Journal of Clinical Emergency

摘　　要：目的：总结毕Ⅱ式胃大部分切除术后急性逆行性胃套叠（ARJGI）诊断及治疗经验。方法：回顾性分析1999-10-2014-09我院收治的6例ARJGI患者的临床资料,所有患者均以腹痛及上消化道出血为首发症状入院,于术中得以确诊,手术方式为肠切除5例,套叠还纳1例。结果：术后患者均未发生吻合口瘘、腹腔感染、切口感染的并发症,术后9~12d痊愈出院,术后随访无类似症状发生。结论：有毕Ⅱ式胃大部分切除手术史的患者,出现腹痛及上消化道出血,辅助检查不能排除ARJGI可能时,应及时手术探查,避免肠坏死、肠切除及死亡等严重并发症发生。ARJGI是胃大部分切除术后极为罕见的严重并发症,应早期诊断并尽早手术。Objective：To summarize the experience on the diagnosis and treatment in patients with acute retrograde jejunogastric intussusception（ARJGI）after BillrothⅡ gastrectomy.Method：Six patients with ARJGI in our department from Oct.1999 to Sept.2014 were studied retrospectively.Abdominal pain and upper gastrointestinal bleeding are their major complaints.They are all diagnosed during the operation,according to whether there is bowel necrosis,5enterectomies and 1reduction were conducted.Result：There are no postoperative complications including anastomotic leakage,intra-abdominal infection,incision infection.And all the patients discharge from hospital successfully on 9-12 dpostoperatively without any similar symptoms occurs after follow-up.Conclusion：For the abdominal pain and upper gastrointestinal bleeding patients with the history of Billorth Ⅱ gastrectomy,emergent operation should be performed without delay when ARJGI is highly suspected after some assistant examination to avoid the intestinal ischemia,bowel resection,and even mortality.ARJGI is a rare severe complication after Billorth Ⅱ gastrectomy,which should be diagnosed early and operated promptly to avoid catastrophic consequences.

关 键 词：急性逆行性胃套叠 毕Ⅱ式胃大部分切除术 诊断 治疗 

分 类 号：R656[医药卫生—外科学]