引用文本：王利明, 常慧静, 孙鹏, 等. 全胃切除术横结肠后位Roux-en-Y重建术后横结肠系膜裂孔疝嵌顿1例并文献复习[J/CD]. 消化肿瘤杂志（电子版）, 2026, 18(2): 292-297.

作者：王利明，常慧静，孙鹏，陈瑛罡

单位：国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院深圳医院　胃肠外科，广东 深圳　518116

Authors：Wang Liming, Chang Huijing, Sun Peng, Chen Yinggang

Unit：Department of Gastrointestinal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, Guangdong, China

摘要：

本文报道1例61岁男性胃癌患者行腹腔镜全胃切除术、横结肠后位Roux-en-Y重建术后3个月内发生横结肠系膜裂孔疝嵌顿的个案。患者以急性腹痛、呕吐起病，上腹部增强计算机断层扫描见大量腹水、小肠缺血及输入袢“鸟嘴状”改变，通过急诊手术确诊并予嵌顿松解、吻合口修补、缺血肠管复苏及系膜裂孔关闭，未行肠切除。患者术后恢复良好，并于术后第9天出院。本文结合文献复习，总结该病的临床特点、发病机制、诊治要点与预防策略。对于行腹腔镜全胃切除术选择横结肠后位Roux-en-Y重建的患者，术中以非吸收缝线彻底关闭横结肠系膜裂孔、Petersen裂孔等所有系膜缺损，可降低小肠内疝梗阻风险。

关键词：全胃切除术；Roux-en-Y吻合；横结肠系膜裂孔疝；内疝

Abstract：

This article reported a 61-year-old male patient with gastric cancer who developed incarcerated transverse mesocolic hernia within 3 months after laparoscopic total gastrectomy with retrocolic Roux-en-Y reconstruction. The patient presented with acute abdominal pain and vomiting. Contrast-enhanced computed tomography (CT) of the upper abdomen showed massive ascites, small bowel ischemia and “bird’s beak” sign of the afferent loop. Emergency operation was performed with hernia release, anastomotic repair, ischemic bowel resuscitation and complete closure of mesenteric defects without bowel resection. The patient recovered uneventfully and was discharged on the 9th postoperative day. Literature review was conducted to summarize the clinical characteristics, pathogenesis, diagnosis, treatment and prevention of this disease. For patients who underwent laparoscopic total gastrectomy with retrocolic Roux-en-Y reconstruction, thorough closure of all mesenteric defects including transverse mesocolic defect and Petersen’s defect with non-absorbable sutures during surgery may reduce the risk of small bowel obstruction due to internal hernia.

Key words：Total gastrectomy; Roux-en-Y anastomosis; Transverse mesocolic hernia; Internal hernia

注：网络优先发布