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经皮内镜下胃造口术并发埋藏式胃造口管综合征

Percutaneous endoscopic gastrostomy complicated by buried bumper syndrome.

作者信息

Sasaki Takamitsu, Fukumori Daisuke, Sato Masayuki, Sakai Koutaro, Ohmori Hitoshi, Yamamoto Fumio

机构信息

First Department of Surgery, Fukuoka University School of Medicine, Fukuoka, Japan.

出版信息

Int Surg. 2003 Apr-Jun;88(2):64-7.

Abstract

We experienced one case of so-called buried bumper syndrome (BBS) in which the bumper at the tip of the gastrostomy tube was buried in the abdominal wall after a percutaneous endoscopic gastrostomy (PEG). A 52-year-old woman had suffered a cerebral hemorrhage, which led her to become bedridden and eventually caused an aggravation of dysphagia, and as a result, the patient received a PEG. On postoperative day 41, the gastrostomy tube became obstructed, making the infusion of nutrients impossible and producing a leakage of nutrients from around the site of insertion. Endoscopy demonstrated that the bumper within the stomach became buried within the submucosa with only the tip of the bumper being partially observed. Abdominal computed tomography (CT) revealed the bumper to be buried in the abdominal wall. Based on these findings, a diagnosis of buried bumper syndrome was established. The gastrostomy tube was thereafter removed percutaneously and successfully replaced by a new tube at the same site. Although BBS is still relatively uncommon, it may be a complication that deserves increasing attention because PEG is expected to be performed more frequently in the future.

摘要

我们遇到了一例所谓的埋藏式胃造口管综合征(BBS),该病例中胃造口管尖端的缓冲装置在经皮内镜下胃造口术(PEG)后埋入了腹壁。一名52岁女性曾发生脑出血,导致卧床不起,最终吞咽困难加重,因此接受了PEG。术后第41天,胃造口管堵塞,无法输注营养物质,且营养物质从插入部位周围渗漏。内镜检查显示胃内的缓冲装置埋入了黏膜下层,仅能部分观察到缓冲装置的尖端。腹部计算机断层扫描(CT)显示缓冲装置埋入了腹壁。基于这些发现,确诊为埋藏式胃造口管综合征。此后,经皮取出胃造口管,并在同一部位成功更换了新管。尽管BBS仍然相对不常见,但由于未来预计PEG的实施会更加频繁,它可能是一种值得更多关注的并发症。

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