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Acute Intestinal Obstruction due to Internal Herniation through the Congenital Mesenteric Defect: Report of 5 Cases

先天性腸繫膜缺損引起之急性腸阻塞:五病例報告

摘要


先天性腸擊膜缺損是一種罕見的疾病,其造成的原因仍無定論,大部份的文獻多主張是發生在胚胎發育過程中。因為缺損的本身易形成腹內疝氣,所以有引起急性的腸阻塞併腸扭轉的可能,甚而引發腸壞死,致使病患因敗血症而死亡。臨床上的確定診斷大多須經向剖腹探查,腹部放射線檢查及消化道顯影可以提供一定的幫助。因患者多無腹部外傷及腹部手衍的病史,易誤診為麻痺性的腸阻塞,而延誤手衍的時機。我們蒐集了過去十一年本院的五例病患,及一些文獻報告,希望能對處理這一罕見的疾病有所幫助。

並列摘要


Congenital mesenteric defect is a rare condition, of which the cause is unknown. Most articles regard it as an embryonal development defect. The mesenteric defect easily leads to internal herniation with possible intestinal obstruction or volvulus. Gangrenous change, sepsis, and death may occur. Most cases are diagnosed at the time of surgery, although the plain film and small bowel series may help in the diagnosis. Misdiagnosis as paralytic ileus and delay in surgical treatment are common because patients have no history of trauma or previous surgery. We report 5 cases of congenital mesenteric hernia collected during the past 11 years, and compare them with other reports.

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