Sklerozirajući mezenteritis kao redak uzrok visokog ileusa

  • Mihailo Bezmarević Clinic for General Surgery, Military Medical Academy, Belgrade, Serbia
  • Darko Mirković Clinic for General Surgery, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Nenad Perišić Clinic for Gastroenterology, Military Medical Academy, Belgrade, Serbia
  • Snežana Cerović Center of Pathology and Forensic Medicine,Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Marina Panišić Clinic for General Surgery, Military Medical Academy, Belgrade, Serbia
  • Saša Micković Clinic for General Surgery, Military Medical Academy, Belgrade, Serbia
  • Ivana Tufegdžić §Center of Pathology and Forensic Medicine, Military Medical Academy, Belgrade, Serbia
  • Jelena Mitrović Primary Health Care Center “Dr Simo Milosevic”, Belgrade, Serbia
  • Zoran Djordjević Institute of Radiology, Military Medical Academy, Belgrade, Serbia
DOI: https://doi.org/10.2298/1378
Ključne reči: panniculitis, peritoneal||, ||paniculitis, peritonealni, intestinal obstruction||, ||creva, opstrukcija, diagnosis||, ||dijagnoza, surgical procedures, operative||, ||hirurgija, operativne procedure, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod. Sklerozirajući mezenteritis je retki patološki entitet koji karakteriše nespecifičnu infiltracija u predelu mezenterijuma, nalik tumoru. Tačna dijagnoza ove bolsti retko se postavlja preoperativno. U cilju dijagnoze, kao i terapije, hirurgija zauzima značajno mesto. Prikazali smo bolesnika sa sklerozirajućim mezenteritisom sa zahvatanjem završnih delova dvanaestopalačnog creva i početnog dela jejunuma koji je imao kliničku sliku opstrukcije gornjeg gastrointestinalnog trakta. Prikaz bolesnika. Prethodno zdrav muškarac, star 46 godina, javio se zbog povraćanja i gubitka telesne mase u poslednjih šest meseci. Klinička slika i nalaz na CT pregledu abdomena, izazvali su sumnju na parapankreasni tumor, te je bolesnik operisan. Nađena je masa koja je infiltrisala koren mezenterijuma, početne delove gornje mezenterične arterije, četvrtu porciju dvanaestopalačnog creva i Treitz-ov ligament, sa dilatacijom dvanaestopalačnog creva i želuca. Intraoperativna biopsija promene ukazivala je na to da se radilo o benignom procesu. Masa je redukovana sa dezopstrukcijom dvanaestopalačnog creva. Definitivni histopatološki nalaz pokazao je da se radilo o fibromatozi u različitim fazama aktivnosti. Postoperativni tok protekao je uredno, bez komplikacija. Nastavljena je imunosupresivna terapija, a na kontrolnom pregledu nakon šest meseci bolesnik nije imao gastrointestinalne tegobe. Zaključak. Sklerozirajući mezenteritis sa zahvatanjem dvanaestopalačnog creva i proksimalnog dela jejunuma sa subakutnom opstrukcijom gornjeg gastrointestinalnog trakta je izuzetno retko stanje. Kod prikazanog bolesnika hirurška intervencija bila je neophodna za postavljanje dijagnoze, ali i kao terapijska procedura.

 

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Objavljeno
2017/01/19
Broj časopisa
Vol. 70 Br. 3 (2013)
Rubrika
Prikaz bolesnika