经口双气囊小肠镜圈套碎石治疗5例小肠结石伴梗阻的临床观察

Clinical observation on 5 cases of small intestinal bezoars with obstruction treated by oral double‑balloon enteroscopy

摘要:

为评估经口双气囊小肠镜圈套碎石治疗小肠结石伴梗阻的安全性和有效性，回顾性分析2021年12月至2023年3月间南京大学医学院附属鼓楼医院诊治的小肠结石伴梗阻患者的临床、内镜、影像、病理和手术相关资料。共纳入5例患者，均为女性，年龄52~83岁，临床表现主要是消化道梗阻，结石长径30~50 mm，位于空肠3例、回肠近段1例、空回交界1例。术前3例经影像学诊断为小肠结石。5例均达到技术成功。4例达到临床成功，梗阻症状完全缓解；1例因合并恶性梗阻临床症状部分缓解。术后5例均未出现明显并发症，随访15~790 d，无复发。结果显示经口双气囊小肠镜圈套碎石治疗小肠结石安全有效，为小肠结石患者提供了除外科手术治疗外的一种新的治疗方法。

Abstract:

To evaluate the safety and efficacy of oral double-balloon enteroscopy for small intestinal bezoars with obstruction, the clinical, endoscopic, imaging, pathological and surgical data of patients with small intestinal bezoars and obstruction treated in Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from December 2021 to March 2023 were retrospectively analyzed. A total of 5 patients, all female, aged 52-83 years, were included. The clinical manifestation was mainly digestive tract obstruction. The diameter of bezoars was 30-50 mm. Three were located in the jejunum, one in the proximal ileum, and one at the jejuno-ileal junction. Three cases were diagnosed as having small intestinal bezoars by imaging examination before operation. All 5 patients achieved technical success. Four patients achieved clinical success, the symptoms of obstruction were completely relieved, and 1 patient was partially relieved due to malignant obstruction. No obvious complication occurred in 5 patients after operation. The follow-up time was 15-790 days, and there was no recurrence. The results showed that oral double-balloon enteroscopy for small intestinal bezoars was safe and effective, providing a new treatment for patients with small intestinal bezoars except for surgery.