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| 选择性腹腔镜结肠切除右盲肠扭转--病例报告及文献复习 Colectomía derecha laparoscópica electiva por vólvulo cecal: reporte de un caso y revisión de la literatura Elective laparoscopic right colectomy for caecal volvulus: case report and literature review Abstract 摘要 Background 背景 Caecal volvulus is an uncommon cause of intestinal obstruction. Its clinical presentation is non-specific, with the diagnosis usually confirmed by barium enema and abdominal computed tomography. Treatment depends on many factors, and minimally invasive approaches are becoming the treatment of choice. 盲肠扭转是一种罕见的肠梗阻的原因。它的临床表现是非特异性的，诊断通常通过钡剂灌肠和腹部计算机断层扫描。治疗取决于许多因素，微创治疗成为首选的治疗方法。 Clinic case 临床案例 A 54 years old female, admitted to the Emergency Department with clinical symptoms of intestinal obstruction. On physical examination she had a palpable, firm, and tympanitic mass in the right abdomen, with peritoneal irritation. The radiographs of the abdomen, barium enema and abdominal computed tomography showed caecal volvulus. As she showed a full remission after the barium enema, with no clinical or biochemical data of systemic inflammatory response syndrome or peritoneal irritation, she was discharged to her home. Two weeks later, a laparoscopic right hemicolectomy was performed with an ileo-transverse extracorporeal anastomosis. Her progress was satisfactory, and she was discharged 4 days after surgery due to improvement. 一位54岁的女性，住进急诊科，有临床症状的肠梗阻。体检时她有一个显而易见的，坚定的，在右腹部臌胀的肿块，伴腹膜刺激。腹部的X线平片、钡灌肠及腹部电脑断层扫描显示盲肠扭转。由于她在钡灌肠后表现完全缓解，没有全身性炎症反应综合征或腹膜刺激的临床或生化数据，她出院回家了。两周后，腹腔镜右半结肠切除术和回肠吻合术进行横向体外吻合。她的进展是令人满意的，她在手术后4天，由于改善出院。 Conclusion 结论 Caecal volvulus is a rare cause of intestinal obstruction, with high mortality rates, and is caused by excessive mobility of the caecum. Its incidence is increasing. Treatment depends on many factors. Early non-surgical untwisting, followed by an elective laparoscopic surgical procedure offers several advantages and reduces mortality. 盲肠扭转是肠梗阻的罕见病因，死亡率高，是由盲肠过度的流动性造成的。其发病率增加。治疗取决于许多因素。早期非手术解除梗阻，其次是为择期腹腔镜手术提供了几个优势，降低死亡率。 Keywords 关键词 Caecal volvulus; Computed tomography of the abdomen; Laparoscopic colectomy; Elective surgery 盲肠扭转；腹部计算机断层摄影术；腹腔镜结肠切除术；选择性外科手术  Figura 1. Placa simple de abdomen de pie con dilatación cecal (flecha negra), niveles hidroaéreos (flechas blancas) y ausencia de aire en ámpula rectal (flecha negra punteada). 图1.简单腹部站立与盲肠扩张（黑色箭头），空气流体水平（白色箭头）和直肠壶腹没有空气的条件（黑色虚线箭头）。  Figura 2. Colon por enema donde se observa imagen en grano de café (flechas blancas). 图2.结肠灌肠，观察到的咖啡豆样图像（白色箭头）。  Figura 3. Tomografía de abdomen. Corte axial con dilatación cecal, nivel hidroaéreo, sin evidencia de neumatosis intestinal ni líquido libre. 图3.腹部CT扫描。轴向切割盲肠扩张，液位没有肠道积气或游离液体的证据。  Figura 4. Laparoscopia final donde se observa íleo transverso anastomosis latero lateral. 图4.腹腔镜横结肠梗阻端侧吻合观察到的很少。  Figura 5. Esquema que ilustra el vólvulo cecal con torsión axial del ciego, colon ascendente e íleon terminal. 图5. 盲肠扭转模式说明了盲肠轴向扭转，升结肠及回肠末端。  Figura 6. Esquema que ilustra la báscula cecal donde se produce un punto de flexión del ciego hacia arriba y anterior del colon ascendente, que provoca un mecanismo valvular de oclusión. 图6. 方案说明发生在盲肠的一点向上弯曲前盲升结肠的机制，导致瓣膜闭塞。 原文： |
