十二指肠先天性狭窄并肠系膜上动脉压迫综合征1例的诊治体会.pdfVIP

东南大学学报( 医学版) 　 2015,Feb;34(1):107 109　 　- JSoutheastUniv(MedSciEdi) ·107 · ·论　 　 著· 十二指肠先天性狭窄并肠系膜上动脉压迫 综合征1例的诊治体会 宿士智,李金,杜彦斌,高峰,于进 (北京市大兴区人民医院普外科,北京　 102600) [摘要] 目的:探讨十二指肠先天性狭窄并肠系膜上动脉压迫综合征(SMACS)的治疗方法。 方法:对1例成 人十二指肠先天性狭窄并SMACS 患者的临床资料进行回顾性分析。 结果:患者因“间断恶心、呕吐30年,加 重6 d”入我院消化内科。 胃镜示,十二指肠降部中下段管腔狭窄(先天性可能)。 转入我科进一步治疗。 术 中见肠系膜上动脉右侧十二指肠扩张显著,术中补充诊断:肠系膜上动脉压迫综合征,遂行十二指肠狭窄隔 膜切除并十二指肠空肠吻合术。 术后患者恢复顺利。 结论:对十二指肠先天性狭窄合并SMACS 的治疗,应 采取狭窄隔膜切除并十二指肠空肠吻合术,而仅采用其中之一的手术方式是不可取的。 [关键词] 十二指肠先天性狭窄;肠系膜上动脉压迫综合征;Treitz韧带 [中图分类号] R615　 　 [文献标识码]A　 　 [文章编号] 1671 6264(2015)01 0107 03- - - doi:10.3969/ j.issn.1671 6264.2015.01.025- Experience on treating a patient with congenital stenosis of duodenum combined with superior mesenteric artery compression syndrome SUShi zhi,LIJin,DUYan bin,GAO Feng,YUJin- - (Department of General Surgery,Daxing Hospital,Bejing 102600,China) [Abstract] Objective:To investigate the treatment of congenital stenosis of duodenum combined with superior mesenteric artery compression syndrome (SMACS).Methods:We retrospectively analyzed the clinical data of 1 case of adult congenital stenosis of duodenum combined with SMACS. Results:The patient was in Department of Internal Medicine for “intermittent nausea, vomiting for thirty years, aggravated for six days”. Gastroscopy showed:the distal of descending part of the duodenum stenosis (maybe congenital). Then this patient was transferred to our department for further treatment. The duodenum right to superior mesenteric artery wasbefound dilatation intraoperation,so SMACS was supplementary diagnosed. We performed duodenal septum resection and duodenum jejunum anastomosis. The postoperative course was smooth. Conclusion: The appropriate treatment should be performed duodenal septum resection and duodenum jejunum an