Volvulus transverzalnog kolona kao hitno hirurško stanje kod neurološki izmenjenog bolesnika

  • Maja Miličković Institut za zdravstvenu zaštitu majke i deteta Republike Srbije "Dr Vukan Čupić"
  • Djordje Savić Department of Abdominal Surgery, Institute for Mother and Child Healthcare of Serbia „Dr. Vukan Čupić“, Belgrade, Serbia
  • Nikola Stanković Department of Anesthesiology, Institute for Mother and Child Healthcare of Serbia „Dr. Vukan Čupić“, Belgrade, Serbia
  • Miroslav Vukadin Department of Abdominal Surgery, Institute for Mother and Child Healthcare of Serbia „Dr. Vukan Čupić“, Belgrade, Serbia
  • Aleksandar Vlahović Department of Plastic and Reconstructive Surgery, Institute for Mother and Child Healthcare of Serbia „Dr. Vukan Čupić“, Belgrade, Serbia
  • Dejana Božić Department of Pathology, Institute for Mother and Child Healthcare of Serbia „Dr. Vukan Čupić“, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP150911015M
Ključne reči: intestinal volvulus||, ||creva, volvulus, colon||, ||kolon, cerebral, palsy||, ||paraliza, cerebralna, comorbidity||, ||komorbiditet, digestive system surgical procedures||, ||hirurgija digestivnog sistema, procedure, colostomy||, ||kolostomija, postoperative complications||, ||postoperativne komplikacije, bronchopneumonia||, ||bronhopneumonija,

Sažetak


Uvod. Volvulus transverzalnog kolona je redak uzrok opstrukcije creva. Predisponirajući faktori su mentalna retardacija, poremećaji motiliteta, hronična konstipacija i kongenitalni megakolon. Prikaz bolesnika. Prikazali smo volvulus transverzalnog kolona kod dečaka sa cerebralnom paralizom starog 16 godina. Hronična konstipacija predstavljala je faktor rizika kod neurološki izmenjenog deteta i dovela je do volvulus-a. Bolesnik  je primljen sa velikom distenzijom trbuha i akutnom respiratornom insuficijencijom. Hitno je odveden u operacionu salu radi eksplorativne laparotomije. Intraoperativno, nađen je volvulus transverzalnog kolona od 360º u pravcu kazaljki na satu. Nakon redukcije volvulus-a, jako uvećan transverzalni kolon reseciran je i otvorena je kolostoma. Postoperativno, bez obzira na dobro funkcionisanje stome i normalan intraabdominalni pritisak, razvili su se brojni i dugotrajni respiratorni problemi. Bolesnik je otpušten iz naše ustanove nakon 8 meseci. Zaključak. Iako je veoma redak u pedijatrijskoj populaciji, u diferencijalnoj dijagnozi akutne opstrukcije debelog creva mora se uzeti u obzir i mogućnost volvulus-a transverzalnog kolona.

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Objavljeno
2017/05/30
Broj časopisa
Vol. 74 Br. 1 (2017)
Rubrika
Prikaz bolesnika