CAJ | 학술논문

胆石性肠梗阻是一种较为少见的机械性肠梗阻,多因胆囊巨大结石通过胆肠内瘘排入肠道引起阻塞性肠梗阻.治疗的关键是梗阻原因的诊断,治疗方法主要为手术治疗.2013年4月苏州大学附属第二医院收治了1例老年胆石性肠梗阻患者.术前经X线片和CT检查胆囊壁增厚与十二指肠粘连窦道形成,左髂区机械性肠梗阻(胆源性结石直径约4 cm),内科治疗3d后行急诊剖腹探查+取石术治疗肠梗阻,术中见胆囊无结石,与家属沟通后未切除胆囊,术后随访观察.随访至2013年12月患者恢复较好,复查B超胆囊肠道内瘘口未显示,胆囊炎症消退.
담석성장경조시일충교위소견적궤계성장경조,다인담낭거대결석통과담장내루배입장도인기조새성장경조.치료적관건시경조원인적진단,치료방법주요위수술치료.2013년4월소주대학부속제이의원수치료1례노년담석성장경조환자.술전경X선편화CT검사담낭벽증후여십이지장점련두도형성,좌가구궤계성장경조(담원성결석직경약4 cm),내과치료3d후행급진부복탐사+취석술치료장경조,술중견담낭무결석,여가속구통후미절제담낭,술후수방관찰.수방지2013년12월환자회복교호,복사B초담낭장도내루구미현시,담낭염증소퇴.
Gallstone ileus is a rare mechanical ileus,which was caused by discharge of giant gall bladder stone to the intestine.Understanding the causes of ileus is the key factor for treatment,and surgical treatment is the treatment of choice.An old patient with gallstone ileus was admitted to the Second Affiliated Hospital of Soochow University in April 2013.Preoperative X ray detection and computed tomography showed gallbladder wall thickening,formation of a sinus tract between the gall bladder and the duodenum,and intestinal ileus in the left iliac region (the diameter of the stone was about 4 cm).The patient received medical treatment for 3 days and then exploratory laparotomy + lithotomy.Gall bladder stones were not detected during the operation,so the gall bladder was preserved.The patient was followed up till December 2013,the sinus tract was disappeared under B sonography,and the cholecystitis was cured.