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| 題 名 | Gallstone Ileus with Cholecystoduodenal and Cholecystocolonic Fistulae: A Case Report=膽結石腸阻塞合併膽囊與十二指腸間的及膽囊與結腸間的瘻管--病例報告 |
|---|---|
| 作 者 | 黃俊雄; 鍾元強; 張景年; | 書刊名 | 中華民國外科醫學會雜誌 |
| 卷 期 | 32:4 民88.07-08 |
| 頁 次 | 頁172-176 |
| 分類號 | 416.24 |
| 關鍵詞 | 膽結石腸阻塞; 膽囊; 十二指腸; 結腸; 瘻管; Gallstone ileus; Cholecystoduodenal fistula; Cholecystocolonic fistula; |
| 語 文 | 英文(English) |
| 中文摘要 | 兩個獨立的膽囊與腸道間的瘻管是極罕見的病例,而合併膽結石腸阻塞則更少見,至今僅有五例文獻報告。腸結石阻塞是不可輕忽的老人急症,因無特異症狀,術前診斷多半不易,且病人多數病弱、年邁且多合併其他疾病,故死亡率仍高達近20%。我們報告的是一位76歲女性病患,主訴為嘔吐,腹脹,及便秘近二十天之久。理學檢查發現中度脫水及腹脹現象;腹部超音波及電腦斷層檢查呈現慢性膽囊炎及膽道積氣:下消化道鋇劑攝影懷疑是膽囊及結腸間瘻管。手術後病人除輕微液漏外,恢復情況良好,無其他併發症。 |
| 英文摘要 | Two separate biliary enteric fistulae associated with gallstone ileus is a very rare entity. Gallstone ileus is an uncommon cause of mechanical intestinal obstruction and caused by the passage of stone through the biliary enteric fistula (most cholecystoduodenal fistula) and by the impaction in the small intestine. We present a 76-year-old woman with symptoms of abdominal distention, vomiting, and constipation. Plain abdominal x-ray showed distended stomach and air-fluid level in the small intestine. Abdominal sonography revealed chronic cholecystitis. Abdominal CT scan disclosed pneumobilia. Barium enema suspected cholecystocolonic fistula. Entero-lithotomy, cholecystectomy, and closureof fistula were performed and two separate biliary enteric fistulae (cholecystoduodenal and cholecystocolonic fistulae) were found. Despite minor leakage, the postoperative course was relatively smooth. |
本系統中英文摘要資訊取自各篇刊載內容。