Lian L, Fazio V, Shen B
Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Dig Liver Dis. 2009 Jul;41(7):e26-8. doi: 10.1016/j.dld.2008.02.004. Epub 2008 Jul 10.
Difficulty intubation is the most common long-term complication after continent ileostomy, which can be associated with nipple valve slippage, parastomal hernia, stenosis. Diagnosis and management of a patient with nipple valve stricture and partial bowel obstruction associated with dietary supplement retention in the pouch reservoir is described. A 50-year-old female patient with ulcerative colitis and a 15-year history of continent ileostomy after total proctocolectomy reported 5-week symptoms of abdominal pain and difficulty in intubating the pouch. Pill bezoar composed of dietary supplement was found in diagnostic pouch endoscopy. Therapeutic pouch endoscopy was performed with balloon dilation of a nipple valve stenosis and retrieval of 224 dietary supplement tablets. Pill bezoar in the pouch is rare. However, patients with continent ileostomy should be advised to avoid taking hard-to-dissolve foods and medications.
插管困难是可控性回肠造口术后最常见的长期并发症，可能与乳头瓣滑脱、造口旁疝、狭窄有关。本文描述了一名患有乳头瓣狭窄和部分肠梗阻且伴有袋状储器内膳食补充剂潴留的患者的诊断和治疗过程。一名50岁的女性溃疡性结肠炎患者，在全直肠结肠切除术后有15年可控性回肠造口病史，报告有5周的腹痛症状及插管困难。在诊断性袋状内镜检查中发现了由膳食补充剂组成的药丸性粪石。进行了治疗性袋状内镜检查，对乳头瓣狭窄进行球囊扩张，并取出224片膳食补充剂片剂。袋状储器内的药丸性粪石很罕见。然而，应建议可控性回肠造口术患者避免食用难溶解的食物和药物。
