脊柱畸形矫正后的肠系膜上动脉综合征

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论证:肠系膜上动脉综合征(superior mesenteric artery syndrome)是罕见的病理,由上肠系膜动脉异常偏离腹主动脉引起,导致十二指肠远端被压缩在主动脉与上肠系膜动脉之间,临床表现为急性肠梗阻:上腹部疼痛、恶心、大量呕吐。在缺乏及时治疗的情况下,患者可能会出现电解质紊乱、严重的营养不足,并增加发生胃穿孔、吸入性肺炎、牛黄形成、血栓栓塞及其他危及生命的并发症而导致死亡的风险。

临床观察:在本病例中,一位17岁的女孩在治疗因术后体重减轻引起的特发性脊柱侧凸时,通过手术矫正脊柱畸形,发现了肠系膜上动脉综合征,患者的身高与体重的比值发生了急剧变化。

讨论:由于采用了一种综合的方法来治疗这种并发症,取得了显著的临床疗效。然而,尽管保守治疗的结果,患者仍有发展成各种严重程度的慢性十二指肠梗阻的风险,可能需要手术治疗。

结论:如果不及时,并不彻底的治疗肠系膜上动脉综合征会增加慢性肠梗阻的风险。这种并发症的治疗始于保守治疗。在保守治疗无效的情况下,如果病情恶化,出现危及生命的情况(出血、穿孔),则需要手术治疗。

作者简介

Angelina Strelnikova

The Turner Scientific Research Institute for Children’s Orthopedics

编辑信件的主要联系方式.
Email: angelina.str.93@gmail.com
ORCID iD: 0000-0003-2013-1553

MD, Anesthesiologist-Intensivist, Department of Anesthesiology, Resuscitation and Intensive Care

俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Aleksandr Kozyrev

The Turner Scientific Research Institute for Children’s Orthopedics

Email: alexkozirev@inbox.ru
ORCID iD: 0000-0002-2828-4063

MD, PhD, Chief Doctor, Anesthesiologist-Intensivist of the Department of Anesthesiology, Resuscitation and Intensive Care

俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Sergei Vissarionov

The Turner Scientific Research Institute for Children’s Orthopedics

Email: vissarionovs@gmail.com
ORCID iD: 0000-0003-4235-5048

MD, PhD, D.Sc., Professor, Correspondent Member of RAS, Deputy Director for Research and Academic Affairs, Head of the Department of Spinal Pathology and Neurosurgery

俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Kirill Kartavenko

The Turner Scientific Research Institute for Children’s Orthopedics

Email: med-kart@yandex.ru
ORCID iD: 0000-0002-6112-3309

MD, PhD, Orthopedic and Trauma Surgeon of the Department of Spinal Pathology and Neurosurgery

俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

Vladislav Murashko

The Turner Scientific Research Institute for Children’s Orthopedics

Email: v.murashko@gmail.com
ORCID iD: 0000-0002-2201-6906

MD, Orthopedic and Trauma Surgeon of the Department of Spinal Pathology and Neurosurgery

俄罗斯联邦, 64, Parkovaya str., Saint-Petersburg, Pushkin, 196603

参考

  1. Farina R, Foti PV, Cocuzza G, et al. Wilkie’s syndrome. J Ultrasound. 2017;20(4):339-342. https://doi.org/10.1007/s40477-017-0257-2.
  2. Welsch T, Büchler MW, Kienle P. Recalling superior mesenteric artery syndrome. Dig Surg. 2007;24(3):149-156. https://doi.org/10.1159/000102097.
  3. Ylinen P, Kinnunen J, Höckerstedt K. Superior mesenteric artery syndrome. A follow-up study of 16 operated patients. J Clin Gastroenterol. 1989;11(4):386-391.
  4. Mathenge N, Osiro S, Rodriguez II, et al. Superior mesenteric artery syndrome and its associated gastrointestinal implications. Clin Anat. 2014;27(8):1244-1252. https://doi.org/10.1002/ca.22249.
  5. Schwartz A. Scoliosis, superior mesenteric artery syndrome, and adolescents. Orthop Nurs. 2007;26(1):19-24. https://doi.org/10.1097/00006416-200701000-00007.
  6. Kumar R, Jaiswal G, Bhargava A, Kundu J. Superior mesenteric artery syndrome: Diagnosis and management. Kathmandu Univ Med J (KUMJ). 2016;14(55):288-291.
  7. Barquín-Yagüez J, Abadía Barno P, García Pérez JC. Superior mesenteric artery syndrome: an uncommon cause of intestinal obstruction. Rev Esp Enferm Dig. 2017;109(1):60.
  8. Oguz A, Uslukaya O, Ülger BV, et al. Superior mesenteric artery (Wilkie’s) syndrome: A rare cause of upper gastrointestinal system obstruction. Acta Chir Belg. 2016;116(2):81-88. https://doi.org/10.1080/00015458. 2016.1139830.
  9. Eisenson DL, Shah KN, Cohen EM, Eberson CP. Unusual mechanism for superior mesenteric artery syndrome after scoliosis surgery. R I Med J. 2017;100(8):32-35.
  10. Todd SR, Marshall GT, Tyroch AH. Acute gastric dilatation revisited. Am Surg. 2000;66(8):709-710.
  11. Дьяконова Е.Ю., Бекин А.С., Поддубный И.В., и др. Острое расширение желудка у детей // Педиатрическая фармакология. – 2014. – Т. 11. – № 3. – С. 99–102. [Dyakonova EY, Bekin AS, Poddubniy IV, et al. Acute gastric dilatation in children. Pediatric pharmacology. 2014;11(3):99-102. (In Russ.)]
  12. Watanabe S, Terazawa K, Asari M, et al. An autopsy case of sudden death due to acute gastric dilatation without rupture. Forensic Sci Int. 2008;180(2-3):e6-e10. https://doi.org/10.1016/j.forsciint.2008.07.005.
  13. Виссарионов С.В., Кокушин Д.Н., Дроздецкий А.П., Белянчиков С.М. Технология использования 3D-KT-навигации в хирургическом лечении детей с идиопатическим сколиозом. – Хирургия позвоночника. – 2012. – № 1. – С. 41–47. [Vissarionov SV, Kokushin DN, Drozdetsky AP, Belyanchikov SM. The 3D-CT navigation technology for surgical treatment of children with idiopathic scoliosis. Spine surgery. 2012;1:41-47. (In Russ.)]. https://doi.org/10.14531/ss2012.1.41-47.
  14. Osegueda de Rodríguez EJ, Hernández-Villegas AC, Serralde-Zúñiga AE, Reyes-Ramírez ALDC. The two sides of superior mesenteric artery syndrome treatment: conservative or surgical management? Nutr Hosp. 2017;34(4):997-1000. https://doi.org/10.20960/nh.1006.
  15. Рыжакова Ю.П., Баиндурашвили А.Г. Синдром спинального вытяжения после оперативной коррекции тяжелого сколиоза // XI Российский национальный конгресс «Человек и его здоровье»; Санкт-Петербург, 21–25 ноября 2006 г. – СПб., 2006. – С. 91. [Ryzhakova YP, Baindurashvili AG. Sindrom spinal’nogo vytyazheniya posle operativnoy korrektsii tyazhelogo skolioza. In: Proceedings of the 11th Russian National Congress “Chelovek i ego zdorov’e”; Saint Petersburg; 21-25 Nov 2006. Saint Petersburg; 2006. (In Russ.)]

补充文件

附件文件
动作
1. JATS XML
2. 图 1。脊椎的X射线以直立 的方式投射

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3. 图 2 。脊椎的X射线 以侧立的方式投射

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4. 图 3。口服造影剂的腹部 器官的X射线

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5. 图 4。通过十二指肠探头引入 对比剂腹部器官的X射线照片

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6. 图 5。腹部器官的重 复X射线照片

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7. 图 6 。综合多层螺旋计算机断层扫描 与胃肠道造影剂以及腹部血管造影: 1 — 主动脉;2 — 上肠系膜上动脉

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8. 图 7。对照计算机断层扫描: 1 — 主动脉;2 — 上肠系膜上动脉

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版权所有 © Strelnikova A., Kozyrev A., Vissarionov S., Kartavenko K., Murashko V., 2020

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