Wong Joelle F S, Ho Henry S S, Tan Y H, Cheng Christopher W S
Department of Urology, Singapore General Hospital, Singapore.
Urology. 2008 Sep;72(3):716.e13-4. doi: 10.1016/j.urology.2007.12.028. Epub 2008 Jul 2.
A 43-year-old man had painless macroscopic hematuria and was diagnosed with a 9-cm renal carcinoma in the lower pole of the left kidney. He underwent laparoscopic transperitoneal left radical nephrectomy (LRN) with an uneventful recovery. Eleven days later, he developed intestinal obstruction (IO). Abdominal computed tomography scan showed dilated small bowels occupying the left renal fossa. Laparotomy revealed closed-loop small bowel obstruction resulting from internal intestinal herniation via a 5-cm mesenteric defect. It was repaired after the herniated bowels were reduced. This case illustrates a rare cause of IO after LRN, in which mesenteric defect is necessary.
一名43岁男性出现无痛性肉眼血尿,被诊断为左肾下极9厘米的肾癌。他接受了腹腔镜经腹左肾根治性切除术(LRN),恢复顺利。11天后,他出现了肠梗阻(IO)。腹部计算机断层扫描显示扩张的小肠占据了左肾窝。剖腹手术发现是通过一个5厘米的肠系膜缺损导致的内疝引起的闭袢性小肠梗阻。在疝出的肠管复位后进行了修复。该病例说明了LRN术后IO的一种罕见原因,其中肠系膜缺损是必要条件。