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The Changes in Etiology and Clinical Features of Non-Traumatic Small Bowel Perforation

机译:非创伤性小肠穿孔的病因和临床特征的变化

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Background/Aims We investigated the clinical features, and treatment outcomes in patients with non-traumatic small bowel perforations and compared these results to the previous study with patients who were diagnosed between 1997 and 2002. Methods Patients who diagnosed non-traumatic small bowel perforation between January 2003 and December 2008 were reviewed retrospectively. Results Of 38 patients of non-traumatic small bowel perforation, the most common etiologies were Crohn's disease (CD) (36.8%), followed by intestinal tuberculosis (ITB) (28.9%) and primary malignancy (15.8%). In the study of 2002, however, the most common etiologies were idiopathic (39.3%), followed by mechanical obstruction (28.6%) and infectious enteritis (14.3%). Of 38 cases, 8 perforation sites were found in the jejunum and 30 in the ileum. The number of perforations was single in 20, two in 15, and over 2 in 3 cases. Twenty-five patients were treated with resection and anastomosis, nine patients with primary closure, and four patients with both procedures. The site and number of perforations, surgical methods, and post-operative complication rates were similar to those of 2002. The perforation patients with ITB had more frequent night sweats and pulmonary tuberculosis findings than those with CD. Conclusions Although the clinical features and surgical outcomes in the 2009 study were similar to those of the previous study conducted in 2003, the etiologies of perforations were different; CD and ITB were two most common etiologies. In addition, clinical characteristics such as night sweats or pulmonary tuberculosis were suggestive findings for the diagnosis of ITB.
机译:背景/目的我们调查了非创伤性小肠穿孔患者的临床特征和治疗结果,并将这些结果与先前的研究与1997年至2002年之间被诊断为患者的患者进行了比较。方法确诊为非创伤性小肠穿孔的患者回顾性分析了2003年1月和2008年12月。结果38例非创伤性小肠穿孔患者,最常见的病因是克罗恩病(CD)(36.8%),其次是肠结核(ITB)(28.9%)和原发性恶性肿瘤(15.8%)。然而,在2002年的研究中,最常见的病因是特发性的(39.3%),其次是机械性阻塞(28.6%)和传染性肠炎(14.3%)。在38例中,在空肠中发现8个穿孔部位,在回肠中发现30个穿孔部位。穿孔数为20例单发,15例为2例,3例为2例以上。 25例患者接受了切除和吻合术,9例接受了原发性闭合,4例接受了两种手术。穿孔的部位和数量,手术方法和术后并发症发生率与2002年相似。ITB穿孔患者的盗汗和肺结核的发生率高于CD患者。结论尽管2009年研究的临床特征和手术结果与2003年进行的先前研究相似,但穿孔的病因有所不同。 CD和ITB是两种最常见的病因。此外,诸如盗汗或肺结核等临床特征是诊断ITB的提示性发现。

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