十二指肠石导致十二指肠梗阻及急性胰腺炎的外科治疗1例

Surgical Treatment of Duodenal Obstruction with Acute Pancreatitis Caused by a Large Duodenolith: A Case Report

摘要: 本文报告了一例罕见的由十二指肠结石导致肠梗阻并继发急性胰腺炎的病例。患者为70岁女性，因上腹胀痛伴恶心呕吐就诊，经腹部CT和MRI检查发现十二指肠内大结石嵌顿，导致肠梗阻及胰腺炎。鉴于结石位置深且无法通过内镜取出，患者接受了空肠切开取石术，成功取出约4 cm × 3 cm × 3 cm的肠石。术后患者恢复良好，痊愈出院。本文讨论了十二指肠结石的来源、肠梗阻导致胰腺炎的发病机制，以及该疾病组合的诊断和治疗策略。强调了在处理类似病例时，全面的影像学检查、及时的手术治疗对于预防严重并发症、改善患者预后的重要性。

Abstract: This paper presents a rare case of duodenal obstruction with secondary acute pancreatitis caused by a large duodenolith. The patient, a 70-year-old female, presented with upper abdominal pain accompanied by nausea and vomiting. Abdominal CT and MRI scans revealed a large stone impacted in the duodenum, leading to intestinal obstruction and pancreatitis. Given the deep location of the stone and its inaccessibility for endoscopic removal, the patient underwent a jejunotomy for stone extraction, successfully removing a stone measuring approximately 4 cm × 3 cm × 3 cm. Postoperatively, the patient recovered well and was discharged in good health. This paper discusses the sources of duodenoliths, the pathogenesis of pancreatitis caused by intestinal obstruction, and the diagnostic and therapeutic strategies for this disease combination. It emphasizes the importance of comprehensive imaging examinations and timely surgical intervention in managing similar cases to prevent severe complications and improve patient outcomes.