Vedat Bayrak, Aziz Sumer, Cetin Kotan
Department of Surgery, Faculty of Medicine, Yüzüncü Yil University, Van, Turkey.
Cases J. 2009 Jul 31;2:8601. doi: 10.4076/1757-1626-2-8601.
The drainage of abdominal cavity by means of tube drains is the oldest method. The herniation of gallbladder through the abdominal wall is very rare. Although there are studies informing evisceration of organs such as small intestines and ovary from drain site; at the literature scanning, no publication has been met with advising gallbladder evisceration from the Pezzer drain site so far.
We describe here the first case in the literature of gallbladder evisceration from the Pezzer drain site. A male case with a history of operated incarcerated right inguinal hernia presented with a surgical abdomen. With a diagnosis of intestinal ischemia, the patient underwent laparotomy. About 200 cc fluid with serous quality has been determined in the abdomen and aspirated. Patchy ischemia zones were observed in ileum, over serous face. No. 30 Pezzer's drain was placed for the intention of drainage, extending from the right side of navel towards rectovesical area. After the drainage stopped patient was discharged from hospital with recovery on the 8(th) postoperative day. One day after the discharge, applied to another general surgery center, by complaining that the intestine protruded through an opening in its surrounding walls of the drain place and that has been gradually enlarged. During the operation it was determined that proximal 2/3 of gallbladder has been protruded to outside of abdomen. Cholecystectomy was performed, and patient recovery was uneventful.
Gallbladder herniation is a pathology requires emergency operation.
通过引流管进行腹腔引流是最古老的方法。胆囊经腹壁疝出非常罕见。尽管有研究报道小肠和卵巢等器官经引流部位脱出；但在文献检索中，目前尚未见到关于胆囊经Pezzer引流部位脱出的报道。
我们在此描述文献中首例胆囊经Pezzer引流部位脱出的病例。一名有右侧嵌顿性腹股沟疝手术史的男性患者出现急腹症。诊断为肠缺血后，患者接受了剖腹手术。术中发现腹腔内有约200毫升浆液性液体并予以抽吸。回肠浆膜面可见片状缺血区。放置了30号Pezzer引流管，从脐右侧向直肠膀胱区延伸以进行引流。引流停止后，患者于术后第8天康复出院。出院一天后，患者因主诉有肠管从引流部位周围壁的开口处突出且逐渐增大，前往另一家普通外科中心就诊。手术中发现胆囊近端2/3已突出至腹外。遂行胆囊切除术，患者恢复顺利。
胆囊疝是一种需要紧急手术的病理情况。
