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[急性结肠假性梗阻(奥吉尔维综合征),全髋关节置换术后的一种危及生命的并发症]

[Acute colonic pseudo-obstruction (Ogilvie's syndrome), a life-threatening complication after total hip replacement].

作者信息

Tezval M, Sehmisch S, Dumont C, Frosch K H, Balcarek P, Stürmer K M

机构信息

Klinik für Unfallchirurgie, Plastische und Wiederherstellungschirurgie der Universitätsklinik Göttingen, Göttingen.

出版信息

Zentralbl Chir. 2009 Jun;134(3):263-6. doi: 10.1055/s-0028-1098698. Epub 2009 Jun 17.

Abstract

INTRODUCTION

In the literature, an acute colonic pseudo-obstruction (Ogilvie's syndrome) is frequently observed as a complication after hip arthroplasty. It results in a massive colon dilatation without mechanical obstructions and can lead to a life-threatening colon perforation with a high mortality.

CASE REPORT

We report on a 81-year-old male patient who suffered from an acetabular fracture after falling down with a concomitant coxarthrosis at the same hip side. A total hip arthroplasty was performed using a Müller cap. Postoperatively, he developed an acute colonic pseudo-obstruction that was treated conservatively with multiple colonoscopic decompressions. The importance of prompt recognition, careful monitoring and appropriate management to reduce morbidity and mortality are supported by this case.

CONCLUSION

Early diagnosis and colonoscopic decompressions play a key role in the therapy for Ogilvie's syndrome. In case of a failure of conservative treatment or peritonism, an early laparotomy and coecostomy are necessary.

摘要

引言

在文献中,急性结肠假性梗阻(奥吉尔维综合征)常被视为髋关节置换术后的一种并发症。它会导致结肠大量扩张而无机械性梗阻,并可能导致危及生命的结肠穿孔,死亡率很高。

病例报告

我们报告一名81岁男性患者,其因跌倒导致髋臼骨折,同侧髋关节同时患有髋关节炎。使用 Müller 帽进行了全髋关节置换术。术后,他出现了急性结肠假性梗阻,通过多次结肠镜减压进行保守治疗。该病例支持了及时识别、密切监测和适当管理以降低发病率和死亡率的重要性。

结论

早期诊断和结肠镜减压在奥吉尔维综合征的治疗中起关键作用。在保守治疗失败或出现腹膜炎的情况下,早期剖腹手术和结肠造口术是必要的。

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