乙状结肠

To the Editor: The medical mystery in the October 4 issue1 involved a 69-year-old man with left inguinoscrotal erythema, swelling, and tenderness after colonoscopy, during which he had undergone polypectomy of a moderately dysplastic tubular adenoma of the sigmoid colon.

10月4日的&医学秘密&涉及一位结肠镜检查术后发生左侧腹股沟红肿、压痛的69岁男性。他在结肠镜检查时切除了乙状结肠中一个中度不典型增生的管状腺瘤。

Methods 15 patients with advanced rectal carcinoma were operated with TPE,including total rectal,distal end of sigmoid colon,bladder,posterior urethra,anus,intrapelvic sexual organ and side Lymphnode,and the survival rate was estimated.

采用Miles手术方式为基础，包括全部直肠。乙状结肠远侧段、膀胱、远侧输尿管、后尿道、肛门及盆腔内的生殖器官，同时行盆腔内的侧方淋巴结清扫，并进行随访。

Methods 15 patients with advanced rectal carcinoma were operated with TPE,including total rectal,distal end of sigmoid colon,bladder,posterior urethra,anus,intrapelvic sexual organ and side lymph node,and the survival rate was estimated.

采用Miles手术方式为基础，包括肿瘤在内全部切除直肠、乙状结肠远侧段、膀胱、远侧输尿管、后尿道、肛门及盆腔内的生殖器官，同时行盆腔内的侧方淋巴结清扫，并进行随访。

Methods 15 patients with advanced rectal carcinoma were operated with TPE,including total rectal,distal end of sigmoid colon,bladder,posterior urethra,anus,intrapelvic sexual organ and side Lymphnode,and the survival rate was estimated.

乙状结肠远侧段、膀胱、远侧输尿管、后尿道、肛门及盆腔内的生殖器官，同时行盆腔内的侧方淋巴结清扫，并进行随访。

Simple right sigmoid colon is a rare congenital dysplasia and differ from transposition of viscera and malrotation.

单纯右位乙状结肠罕见，属先天发育异常，不同于内脏转位及先天性肠旋转不良。

****** right sigmoid colon is a rare congenital dysplasia and differ from transposition of viscera and malrotation.

单纯右位乙状结肠罕见，属先天发育异常，不同于内脏转位及先天性肠旋转不良。

Because preoperative differentiation of the three hernia types involving the sigmoid mesocolon is often difficult, the diagnosis is confirmed only with surgical management in most cases.

由于术前鉴别这三种累及乙状结肠系膜的疝常常很困难，因此在绝大多数的病例中只有通过手术才能确诊。

The defect was 3 cm in diameter and was located in the anterior layer of the left side of the sigmoid mesocolon.

缺损直径3cm，位于乙状结肠系膜左侧的前层。

C Diagram of the surgical findings shows that 20 cm of jejunum, located 230 cm from the ligament of Treitz, was herniated into a defect on the left side of the sigmoid mesocolon.

手术表现的示意图显示距Treitz韧带230cm的空肠有约20cm经乙状结肠系膜左侧的缺损疝出。

Results One case with transverse mesocolon pore hernia, one with obturator hernia and one with paracecal hernia were confirmed by exploratory laparotomy. There were six cases whose hernias resulted from the fall of export jejuna into import jejuna after Billroth II anastomoses in front of colons, five from the pelvic bottoms' peritoneal fissure and four from the fissure appearing between descending colon and lateral abdominal wall after Miles' operation, one from greater omental adhesion to sigmoidal wall after sigmoidostomy, and one from inflammatory adhesion on the basis of Meckel's diverticulum. The other 17 cases' hernias (48.7%) were caused by the fissure among celiac adhesive bands, peritonea, celiac organs, enteric walls and intestines.

结果 剖腹探查手术证实为横结肠系膜裂孔疝1例；闭孔疝1例；盲肠旁疝1例；毕Ⅱ式结肠前吻合术后输出段空肠疝入输入段空肠与横结肠系膜间隙6例；Miles术后盆底腹膜裂开所致内疝5例；Miles术后降结肠与侧腹壁形成的间隙致内疝4例；大网膜与乙状结肠造口肠壁粘连形成内疝1 例；1例在梅克尔憩室基础上发生炎性粘连形成腹内疝；因腹腔粘连带与腹膜、腹腔脏器、肠壁、肠与肠之间的孔隙改变形成内疝17例（48.7%）。

This one mode pays close attention to network credence foundation of the businessman very much.

这一模式非常关注商人的网络信用基础。

Cell morphology of bacterial ghost of Pasteurella multocida was observed by scanning electron microscopy and inactivation ratio was estimated by CFU analysi.

扫描电镜观察多杀性巴氏杆菌细菌幽灵和菌落形成单位评价遗传灭活率。