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A Case of Choledocholithiasis and Intestinal Malrotation in an Adolescent with Repaired Gastroschisis

机译:修复型胃裂症患者青少年胆囊结石症和肠旋转不良一例

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摘要

Most infants with repaired gastroschisis develop normally and remain in good health. About 10% of patients with gastroschisis have other malformations. We report a case of choledocholithiasis and intestinal malrotation in an adolescent with repaired gastroschisis. A 17-year-old girl presented with fever, jaundice, and abdominal pain. She had undergone an operation to repair gastroschisis at birth. Physical examination revealed icteric sclera, a tight abdominal wall, and a longitudinal surgical scar at the midline. An abdominal computed tomography scan revealed a round calcifying lesion near the pancreas and a midline-positioned liver and gallbladder. Absence of the retroperitoneal duodenum and the anterior and left-sided position of the superior mesenteric vein compared with the superior mesenteric artery were observed. Results of abarium examination revealed intestinal malrotation. Endoscopic retrograde cholangiopancreatography revealed diffuse dilatation of the biliary trees and a malpositioned gallbladder. A single stone was removed by using a basket. The clinical symptoms improved after the patient underwent endoscopic retrograde cholangiopancreatography.
机译:胃气管修补术的大多数婴儿正常发育并保持健康。大约10%的胃痉挛患者患有其他畸形。我们报告了一例胆总管结石症和肠道营养不良的青少年患者。一名17岁女孩出现发烧,黄疸和腹痛。她在出生时曾接受过修补胃s裂的手术。体格检查发现黄疸巩膜,腹壁紧绷,中线有纵向手术疤痕。腹部计算机断层扫描显示胰腺附近有圆形钙化病变,中线位于肝脏和胆囊。观察到腹膜后十二指肠的缺失以及肠系膜上静脉与上肠系膜动脉的左前和左侧位置。钡剂检查结果显示肠蠕动。内镜逆行胰胆管造影显示胆管树的弥散性扩张和胆囊错位。使用篮子除去一块石头。患者接受内镜逆行胰胆管造影后,临床症状得到改善。

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