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词汇介绍
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解析
volvulus 英 ['vɒlvjʊləs] 美 ['vɒlvjələs]
释义 n. 肠扭结
复数 volvuluses
例句 Colonic obstruction is, except in the case of volvulus, chronic.
结肠梗阻,除了肠扭转的情况,都是慢性的。
概述
概述
肠扭转(volvulus)是一段肠管甚至全部小肠及其系膜沿系膜轴扭转360°~720°,因此,既有肠管的梗阻,又有肠系膜血液循环中断,是肠梗阻中病情凶险、发展迅速的一类。
临床表现
肠扭转是闭襻性肠梗阻加绞窄性肠梗阻,发病急骤,发展迅速。起病时腹痛剧烈且无间歇期,早期即可出现休克。肠扭转的好发部位是小肠、乙状结肠和肓肠,临床表现各有特点。
(1)小肠扭转表现为:①突然发作的剧烈腹部绞痛,多在脐周围,常为持续性疼痛阵发性加剧,由于肠系膜受到牵拉,疼痛可放射至腰背部;②呕吐频繁,腹胀以某一部位特別明显,腹部有时可扪及压痛的扩张肠襻;③肠鸣音减弱,可闻及气过水声;④腹部X线检查有时可见空肠和回肠换位,或排列成多种形态的小跨度卷曲肠襻等特有的征象。
(2)乙状结肠扭转表现为:①腹部持续胀痛,左腹部明显膨胀,可见肠型;②腹部压痛及肌紧张不明显;③腹部X线平片可见马蹄状巨大的双腔充气肠襻,圆顶向上;立位可见两个液平面;④钡剂灌肠X线检查见扭转部位钡剂受阻,钡影尖端呈“鸟嘴”形。
治疗
一般应及时手术治疗,将扭转的肠襻按其扭转方向回转复位。复位后应细致观察血液循环恢复的情况,明确有坏死的肠段应切除。对有怀疑的长段肠襻应设法解除血管痉挛,观察其生
机,争取保留较长的小肠。
Sigmoid Volvulus复制标题
乙状结肠扭转
发表时间:2019-06-25
影响指数:51.3
作者: Ioana Baiu
期刊:JAMA
The sigmoid colon is an S-shaped part of the colon that is in the left lower side of the abdomen, above the rectum. With age, this part of the colon or its attachments to the abdominal wall stretch out, allowing it to twist on itself, similar to the twisting of a long balloon, resulting in a volvulus. When this happens, the colon becomes blocked. In addition, the blood supply may be reduced, leading to injury or death of the tissues of that part of the colon. If not treated quickly, this can result in a perforation, a hole in the bowel through which stool and gas can spill into the abdomen. Perforations can be fatal without urgent intervention.Older age,chronic constipation,and living in a nursing home increase the risk of having sigmoid volvulus.
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