Barbagallo Francesco, Castello Giorgio, Latteri Saverio, Grasso Emanuele, Gagliardo Salvatrice, La Greca Gaetano, Di Blasi Michele
Department of Surgical Sciences, Transplantation and Advanced Technologies, University of Catania, Via Messina 354 95126 Catania, Italy.
World J Gastroenterol. 2007 May 28;13(20):2889-91. doi: 10.3748/wjg.v13.i20.2889.
Colonic perforation during endoscopic diagnostic or therapeutic procedures, represents an uncommon occurrence even if, together with haemorrhage, it is still the most common complication of colonoscopy, with an incidence ranging between 0.1% and 2% of all colonoscopic procedures. The ideal treatment in these cases remains elusive as the endoscopist and the surgeon have to make a choice case by case, depending on many factors such as how promptly the rupture is identified, the condition of the patient, the degree of contamination and the evidence of peritoneal irritation. Surgical interventions both laparotomic and laparoscopic, and other medical non-operative solutions are described in the literature. Only three cases have been reported in the literature in which the endoscopic apposition of endoclips was used to repair a colonic perforation during colonoscopy. Ours is the first case that the perforation itself was caused by the improper functioning of a therapeutic device.
在内镜诊断或治疗过程中发生的结肠穿孔，即便与出血一同仍是结肠镜检查最常见的并发症，但发生率仅占所有结肠镜检查的0.1%至2%，所以仍属罕见情况。由于内镜医师和外科医生必须根据诸多因素，如穿孔发现的及时性、患者状况、污染程度以及腹膜刺激征等，逐案做出选择，因此这些病例的理想治疗方法仍不明确。文献中描述了剖腹手术和腹腔镜手术等外科干预措施以及其他非手术治疗方案。文献中仅报道了3例在结肠镜检查期间使用内镜夹对合修复结肠穿孔的病例。我们的病例是首例穿孔由治疗设备功能异常导致的情况。
