十二指肠旁疝七例诊治体会  

Diagnosis and treatment of para-duodenal hernia:a retrospective analysis of 7 cases

作　　者：张涛涛 蒋柳 张向文 刘长青 李宇津 邱成泽 祖国 李文斌 赵国华 梁怀祝 Zhang Taotao;Jiang Liu;Zhang Xiangwen;Liu Changqing;Li Yujin;Qiu Chengze;Zu Guo;Li Wenbin;Zhao Guohua;Liang Huaizhu(The Second Gastric&Intestinal Department,Dalian Municipal Central Hospital Affiliated of Dalian Medical University,Liaoning Dalian 116033,China;Department of Abdominal Emergency Surgery,The First Affiliated Hospital of Dalian Medical University,Liaoning Dalian 116011,China)

机构地区：[1]大连医科大学附属大连市中心医院胃肠二科,辽宁大连116033 [2]大连医科大学附属第一医院腹部急症外科,辽宁大连116011

出　　处：《腹部外科》2020年第4期293-296,共4页Journal of Abdominal Surgery

摘　　要：目的探讨十二指肠旁疝(para-duodenal hernia,PDH)的诊断和外科治疗。方法对2014年1月1日至2019年1月1日大连医科大学附属大连市中心医院收治的7例十二指肠旁疝临床资料进行回顾性分析。结果7例病人均行腹部CT检查,仅2例术前怀疑十二指肠旁疝。6例病人行急诊手术探查,其中,3例行剖腹探查,腹内疝还纳,十二指肠旁隐窝处系膜关闭;3例行腹腔镜下探查,中转开腹后行小肠还纳。1例病人为代谢手术术中偶然发现十二指肠旁疝,行腹腔镜下十二指肠旁隐窝处系膜关闭。所有病人均痊愈出院,无并发症,随访期间内无腹内疝复发及肠梗阻发作病例。结论十二指肠旁疝临床少见,术前诊断困难,需充分了解该病特点,避免漏诊或误诊。Objective To summarize the experience of diagnosis and treatment for para-duodenal hernia(PDH).Methods The clinical data of 7 cases of paraduodenal hernia admitted to Dalian Central Hospital of Dalian Medical University from January 1,2014 to January 1,2019 were retrospectively analyzed.Results Abdominal CT examinations were performed in all the 7 patients,and only 2 patients were suspected para-duodenal hernia.Emergency surgical explorations were performed in 6 patients,among which 3 patients underwent laparotomy,the internal hernias were recovered,and the mesothelium of the para-duodenal recess was closed.Three laparoscopic explorations were performed,and the small intestine was restored after laparotomy.One patient had an incidental finding of a paraduodenal hernia during metabolic surgery and underwent laparoscopic closure of the duodenal accessory recess.All patients were recovered and discharged without complications.There was no recurrence of intra-abdominal hernia and intestinal obstruction during follow-up.Conclusion Para-duodenal hernia is rare in clinic and difficult to be diagnosed preoperatively.It is necessary to fully understand the characteristics of the disease and avoid missed diagnosis or misdiagnosis.

关 键 词：十二指肠旁疝 诊断 外科手术 

分 类 号：R656.2[医药卫生—外科学]