급성 장폐색을 일으킨 십이지장주위탈장의 임상분석
Clinical Analysis of an Acute Intestinal Obstruction with a Paraduodenal Hernia
김기환, 윤영철, 서학준, 안창혁, 진형민, 김정수, 전해명, 임근우,
소속 상세정보
김기환 ( Kim Kee-Hwan )
가톨릭대학교 의과대학 의정부성모병원 외과학교실
윤영철 ( Youn Young-Chul )
가톨릭대학교 의과대학 의정부성모병원 외과학교실
서학준 ( Seo Hak-Jun )
가톨릭대학교 의과대학 의정부성모병원 외과학교실
안창혁 ( An Chang-Hyeok )
가톨릭대학교 의과대학 의정부성모병원 외과학교실
진형민 ( Chin Hyung-Min )
가톨릭대학교 의과대학 의정부성모병원 외과학교실
김정수 ( Kim Jeong-Soo )
가톨릭대학교 의과대학 의정부성모병원 외과
전해명 ( Jeon Hae-Myung )
가톨릭대학교 의과대학 의정부성모병원 외과학교실
임근우 ( Lim Keun-Woo )
가톨릭대학교 의과대학 의정부성모병원 외과
KMID : 0371320040660060484
Abstract
Purpose: A paraduodenal hernia is an uncommon congenital disease that manifests as an intestinal obstruction, which may lead to strangulation and, subsequently, result in gangrene of the intestine. In this retrospective study, 12 paraduodenal hernia cases were evaluated and the clinical prognostic factors investigated.
Methods: Paraduodenal hernias leading to intestinal obstructions were noted in 12 patients. The patients were retrospectively evaluated with respect to signs and symptoms. The laboratory and radiological findings, type of operation, time elapsed between the onset of symptoms and laparotomy and postoperative complications and hospital stays were also reviewed. The relationships between clinical factors and outcomes were also statistically evaluated.
Results: In our series, postoperative short bowel syndrome was encountered in one patient (case 1) with bowel strangulation, but there were no mortalities. The time elapsed between the onset of symptoms and laparotomy was found to be longer in the patients with strangulation than in those without (6.8±4.5 day versus 4.1±3.6 day). Additionally, the postoperative hospital stay was longer in those patients with strangulation (24.4±1.6 day versus 15.3±7.7 day), but the relationship was not statistically significant (P=0.283 and 0.130, respectively).
Conclusion: Since the preoperative diagnosis of a paraduodenal hernia is very difficult, due to the lack of specific signs and symptoms, the postoperative complications can only be decreased with early surgical intervention in those patients with an acute intestinal obstruction. Although the postoperative morbidity and mortality were not correlated with any of the factors evaluated in this study, further study will be needed to evaluate the significance of the time elapsed between the onset of symptoms and a laparotomy as a prognostic factor.
키워드
장폐색;십이지장주위 탈장;예후인자;Intestinal obstruction;Paraduodenal hernia;Prognostic factor
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