论文部分内容阅读
患者女,12岁。主诉间歇性呕吐12年,加重7天于1994年1月11日入院。呕吐为胃内容物,含有胆汁。查体:发育正常,营养稍差。心肺正常,腹平软,未见胃肠形,无压痛,未触及包块,肝脾未触及,中上腹可闻及振水音,肠鸣音正常。钡餐检查见十二指肠内钡剂在水平部通过受阻,挤压时钡剂仍不能通过,并返流入降部、20分钟后见小肠内有少量钡剂。临床诊断:先天性十二指肠水平部不全梗阻。 手术所见:胃及幽门部正常,十二指肠增粗,直径3cm,肠壁增厚;全部结肠位于左侧腹部,阑尾位于左上腹,屈氏韧带及空肠起始部位于右中上腹部,全部小肠位于右侧腹部,肠系膜上动脉位
Female patient, 12 years old. The main complaint of intermittent vomiting for 12 years, increased 7 days in January 11, 1994 admission. Vomit for the stomach contents, containing bile. Physical examination: normal development, slightly less nutritious. Normal heart and lung, abdominal soft, no gastrointestinal shape, no tenderness, no palpable mass, liver and spleen not touched, in the upper abdomen can be heard and vibration sound, bowel sounds normal. Barium meal examination to see the barium in the duodenum at the level through the obstruction, the barium can not pass extrusion and back into the descending part of the small intestine after 20 minutes to see a small amount of barium. Clinical diagnosis: incomplete congenital duodenal obstruction. Surgical findings: normal stomach and pylorus, duodenal thickening, diameter 3cm, thickening of the intestinal wall; all the colon is located on the left abdomen, appendix in the left upper quadrant, the flexor ligament and jejunum start in the right middle and upper abdomen , All the small intestine in the right abdomen, superior mesenteric artery