【摘要】 目的结合临床病例探讨成人回肠重复畸形的临床诊断和治疗。方法收集1996～2004年我院住院的4例回肠重复畸形患者,其中3例以消化道出血、1例以腹部包块为主要症状。4例均行结肠镜检查未发现明确病灶。3例出血患者均行胃镜检查,2例行小肠镜检查,1例行电子胶囊内镜检查,除怀疑血管畸形外,未发现明确异常。4例患者均行剖腹探查手术,手术标本送病理检查。结果术中发现回肠距回盲部11～70cm处有长度分别为7～20cm的重复回肠肠管,有独立的肠系膜和血供,1例并发异位胰腺,1例伴回盲部炎性包块。病理结果提示4例均为回肠重复畸形,1例有胃黏膜异位。结论回肠重复畸形多在婴幼儿期被发现,成人极为少见,临床上可表现为腹痛、包块、消化道出血等,通过辅助检查一般较难在术前作出明确诊断。手术探查时能发现重复的肠管,手术医师需对该病有充分的了解和认识,才能避免误诊误治。更多还原

【Abstract】 Objective To discuss the diagnosis and treatment of adult ileal duplication with clinical cases.Methods Four cases of adult ileal duplication admitted in our department from 1996 to 2004 were analyzed.Three out of 4 had intestinal bleeding,and 1 had abdominal mass as the major symptom.All of the cases received colonoscopy with no significant finding.Among 3 cases with intestinal bleeding who received gastroscopy,2 had small intestinal scopy,and 1 had capsule intestinal scopy.Apart from the suspicions of abnormality of blood vessels,there was no positive finding.All 4 cases received surgery of abdominal exploration.Results The duplications of ileum in the length of 7-20 cm were found 11-70 cm proximal to ileocecum.Duplicated ileums had their own mesenteric and blood supply.One case was with ectopic pancreas,and another with ileocecum inflammatory mass.Pathological report confirmed the clinical diagnosis,with 1 case had ectopic gastric mucosal.Conclusion Ileal duplications are rarely seen in adults.Clinical symptoms may include abdominal pain,abdominal mass,and gastrointestinal bleeding.Surgeons should be aware of this condition when performing abdominal exploration.更多还原