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대망탈장을 동반한 에스상결장 염전에 의한 대장폐쇄: 예

Colonic Obstruction Caused by Sigmoid Volvulus Combined with a Transomental Hernia: A Case Report

대한대장항문학회지 2008년 24권 3호 p.214 ~ 218
최평화 ( Choi Pyong-Wha ) - 인제대학교 의과대학 일산백병원 외과학교실

허태길 ( Heo Tae-Kil ) - 인제대학교 의과대학 일산백병원 외과학교실
박제훈 ( Park Je-Hoon ) - 인제대학교 의과대학 일산백병원 외과학교실
이명수 ( Lee Myung-Soo ) - 인제대학교 의과대학 일산백병원 외과학교실
김철남 ( Kim Chul-Nam ) - 인제대학교 의과대학 일산백병원 외과학교실
장석효 ( Chang Surk-Hyo ) - 인제대학교 의과대학 일산백병원 외과학교실
김남훈 ( Kim Nam-Hoon ) - 인제대학교 의과대학 일산백병원 내과학교실
배원기 ( Bae Won-Ki ) - 인제대학교 의과대학 일산백병원 내과학교실
문영수 ( Moon Young-Soo ) - 인제대학교 의과대학 일산백병원 내과학교실

Abstract


The case of sigmoid volvulus combined with a transomental hernia is reported. A 70-year-old man was admitted to our hospital with mild abdominal pain and distension. Although no signs of peritoneal irritation were apparent, a plain abdominal X-ray showed a markedly dilated loop of the sigmoid colon, and CT revealed a whirl pattern of the sigmoid mesentery. These findings suggested sigmoid volvulus. Colonoscopic reduction was attempted as an initial nonoperative treatment, and an urgent laparotomy was performed after the reduction failed. The sigmoid loop was herniated through the great omentum, with torsion in the clockwise direction. The colon was manually untwisted in the counter-clockwise direction, and the sigmoid loop was released by dividing the great omentum. During this one- stage operation, intraoperative colonic irrigation, sigmoid resection, and primary anastomosis were performed. The postoperative course was uneventful. Although sigmoid volvulus combined with a transomental hernia is rare, urgent surgical intervention is essential on failure of endoscopic reduction. J Korean Soc Coloproctol 2008;24:214-218

키워드

에스장결장염전;대망탈장
Sigmoid volvulus;Transomental hernia
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