Aumann G, Petersen S, Pollack T, Hellmich G, Ludwig K
Department of General and Abdominal Surgery, General Hospital Dresden-Friedrichstadt, Teaching Hospital Technical University of Dresden, Friedrichstrasse 41, D-01067, Dresden, Germany,
Tech Coloproctol. 2004 Mar;8(1):41-3. doi: 10.1007/s10151-004-0050-z.
Stapled rectal mucosectomy (SRM) became a widely accepted surgical procedure for haemorrhoids. One of the rare complications is severe bleeding. We report the case of a patient who underwent SRM for thirddegree haemorrhoids. In addition, he suffered symptoms of outlet obstruction, although defecography showed no serious disease. One day after SRM, the patient complained of abdominal pain and peritonitis. Computed tomography revealed blood in the abdomen. The patient underwent laparotomy, which revealed a deep enterocele that reached down to the level of the sphincteric muscle. The ventral part of the stapled ring was placed intraperitoneally, and a longitudinal defect of the rectal serosa was observed. The serosa defect was sutured and a diverting sigmoid stoma was carried out. The patient left the hospital 10 days later. We emphasize vigilance for undetected enteroceles in mucosal prolapse syndrome combined with defecation problems.
吻合器直肠黏膜切除术（SRM）已成为一种广泛被接受的治疗痔疮的外科手术。其罕见并发症之一是严重出血。我们报告一例因三度痔疮接受SRM手术的患者。此外，尽管排粪造影未显示严重疾病，但他仍有出口梗阻症状。SRM术后一天，患者主诉腹痛和腹膜炎。计算机断层扫描显示腹腔内有血液。患者接受了剖腹手术，发现一个深的直肠膨出，延伸至括约肌水平。吻合器环的腹侧部分位于腹腔内，观察到直肠浆膜有纵向缺损。对浆膜缺损进行了缝合，并做了乙状结肠转流造口术。患者10天后出院。我们强调对于合并排便问题的黏膜脱垂综合征中未被发现的直肠膨出要保持警惕。
