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[胃内食物团块作为减重手术并发症。病例报告及文献复习]

[Gastric food bezoar as a complication of bariatric surgery. Case report and review of the literature].

作者信息

Zapata R, Castillo F, Córdova A

机构信息

Servicio de Gastroenterología, Clínica Alemana, Santiago, Chile.

出版信息

Gastroenterol Hepatol. 2006 Feb;29(2):77-80. doi: 10.1157/13083903.

Abstract

In the last few years bariatric surgery has become an excellent therapeutic alternative for the treatment of morbid obesity. Food bezoar as a cause for obstruction seems to be a very infrequent postoperative complication. It has only been published as anecdotal case reports. We describe a female patient with morbid obesity (weight, 131 kg; body mass index, 45) who underwent laparoscopic bariatric surgery (subtotal 95% gastrectomy with gastroyeyunoanastomosis in Roux-Y) obtaining a significant weight reduction (51 kg) in the next few months post surgery. She developed a food bezoar in the gastric remnant as a late complication of surgery (13 months after bariatric surgery) and presented as a gastric outlet acute obstruction with persistent vomiting and satiety. The diagnosis and treatment was performed through an upper GI endoscopy. It is important to consider this complication in patients with persisting vomiting after this kind of surgery. In the near future we will probably have a significant amount of patients operated due to morbid obesity and we may see this kind of complication more frequently.

摘要

在过去几年中,减肥手术已成为治疗病态肥胖的一种极佳治疗选择。食物团块作为梗阻原因似乎是一种非常罕见的术后并发症。仅有作为个案报道发表过相关内容。我们描述了一名病态肥胖女性患者(体重131千克;体重指数45),她接受了腹腔镜减肥手术(95%胃大部切除术,Roux-Y式胃空肠吻合术),术后几个月体重显著减轻(51千克)。她在术后较晚阶段(减肥手术后13个月)出现胃残余物形成食物团块,表现为胃出口急性梗阻,伴有持续呕吐和饱腹感。通过上消化道内镜检查进行了诊断和治疗。对于此类手术后持续呕吐的患者,考虑这种并发症很重要。在不久的将来,可能会有大量因病态肥胖接受手术的患者,我们或许会更频繁地见到这种并发症。

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