罕見腸扭轉腹痛難耐 醫院與偏鄉醫療站遠距合作解病苦
2022-07-19 記者陳宜琳/嘉義報導
大埔鄉余姓婦人腹部經常反覆絞痛，近來加劇難耐，在大埔醫療站醫師建議下，到大林慈濟看診，經李政鴻醫師診斷為罕見的小腸扭轉，在開刀治療後回復健康（圖：大林慈濟提供）
一名住在大埔的余姓婦人二年前開始腹部經常反覆絞痛，近來更逐漸加劇難耐，大林慈濟醫院大埔醫療站的醫師幫忙治療緩解外，更幾度建議到大林做進一步治療，終於由一般外科李政鴻醫師診斷為罕見的小腸扭轉，在開刀治療後回復健康，繼續投入志工行列。
大林慈濟醫院從二十多年前承接大埔醫療站後，派駐醫師全年無休提供醫療服務，為此挽救許多面臨危及的生命。這名66歲婦人腹部經常性絞痛，有時甚至痛到無法站、坐、躺，原以為只是腸胃道消化不良，每次疼痛發作會就近到大埔醫療站由林英龍醫師診治。用心想幫病人解決問題的林醫師，發現病人的症狀可能是一般外科罕見情況，並找文獻佐證，建議婦人到大林找李政鴻醫師協助。
一名住在大埔的余姓婦人二年前開始腹部經常反覆絞痛，近來更逐漸加劇難耐，大林慈濟醫院大埔醫療站的醫師幫忙治療緩解外，更幾度建議到大林做進一步治療，終於由一般外科李政鴻醫師診斷為罕見的小腸扭轉，在開刀治療後回復健康，繼續投入志工行列。
大林慈濟醫院從二十多年前承接大埔醫療站後，派駐醫師全年無休提供醫療服務，為此挽救許多面臨危及的生命。這名66歲婦人腹部經常性絞痛，有時甚至痛到無法站、坐、躺，原以為只是腸胃道消化不良，每次疼痛發作會就近到大埔醫療站由林英龍醫師診治。用心想幫病人解決問題的林醫師，發現病人的症狀可能是一般外科罕見情況，並找文獻佐證，建議婦人到大林找李政鴻醫師協助。
李政鴻醫師表示，多虧林醫師的診治與建議，當看到電腦斷層檢查後，立即確認是罕見的小腸扭轉。腸扭轉的程度可分為輕、中、重度，重度是轉了好幾圈，若未在二十四小時內開刀，會因腸子壞死而死亡。輕度則是轉了半圈，沒有什麼症狀，或者只是覺得肚子有些怪怪的。這位病人則是屬於中度腸扭轉，腸子轉了一圈多，腸子要通不通有點充血，所以會反覆發作，導致這一兩年來的情況加劇。
李政鴻指出，供應小腸的腸系膜內有動脈和靜脈，正常時不會有東西阻擋，而病人則是腸子勒住腸系膜而覺得不舒服，若是勒太多圈就會造成腸子壞死，這時候最好儘快開刀處理，因為腸扭轉而讓腸子一次比一次水腫，雖然不至於馬上黑掉，卻因旋轉導致腸子充血，就像手指頭戴上比較小的戒指，會因為充血而呈現紅腫，若不處理到最後還是可能造成腸子壞死。比起診斷的難度高，手術相對簡單，
造成腸扭轉的原因可能是腫瘤或沾黏所造成，而婦人則是先天腸系膜比較長在肚子裡旋轉，但因卡住而沒有轉更多圈，算是不幸中的大幸。李政鴻說，矯正手術約四十分鐘，把扭轉的腸子解開，並把腸系膜順著腸子的方向縫在腹壁上，讓腸子不至於再旋轉，術後不會有什麼後遺症，也大幅改善腸子阻塞與紅腫的情況。
李政鴻醫師表示，病人反覆發作時很無助，還好有大埔醫療站就近協助，林醫師提供醫療、諮詢外，並鼓勵問題還是要處理，讓她有信心並勇敢的下山接受治療，促成大林與大埔兩地遠距合作，圓滿處理問題。
李政鴻醫師表示，多虧林醫師的診治與建議，當看到電腦斷層檢查後，立即確認是罕見的小腸扭轉。腸扭轉的程度可分為輕、中、重度，重度是轉了好幾圈，若未在二十四小時內開刀，會因腸子壞死而死亡。輕度則是轉了半圈，沒有什麼症狀，或者只是覺得肚子有些怪怪的。這位病人則是屬於中度腸扭轉，腸子轉了一圈多，腸子要通不通有點充血，所以會反覆發作，導致這一兩年來的情況加劇。
李政鴻指出，供應小腸的腸系膜內有動脈和靜脈，正常時不會有東西阻擋，而病人則是腸子勒住腸系膜而覺得不舒服，若是勒太多圈就會造成腸子壞死，這時候最好儘快開刀處理，因為腸扭轉而讓腸子一次比一次水腫，雖然不至於馬上黑掉，卻因旋轉導致腸子充血，就像手指頭戴上比較小的戒指，會因為充血而呈現紅腫，若不處理到最後還是可能造成腸子壞死。比起診斷的難度高，手術相對簡單，
造成腸扭轉的原因可能是腫瘤或沾黏所造成，而婦人則是先天腸系膜比較長在肚子裡旋轉，但因卡住而沒有轉更多圈，算是不幸中的大幸。李政鴻說，矯正手術約四十分鐘，把扭轉的腸子解開，並把腸系膜順著腸子的方向縫在腹壁上，讓腸子不至於再旋轉，術後不會有什麼後遺症，也大幅改善腸子阻塞與紅腫的情況。
李政鴻醫師表示，病人反覆發作時很無助，還好有大埔醫療站就近協助，林醫師提供醫療、諮詢外，並鼓勵問題還是要處理，讓她有信心並勇敢的下山接受治療，促成大林與大埔兩地遠距合作，圓滿處理問題。
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