结肠镜检查后出现伴有绞窄性肠袢的膈疝：病例报告
Diaphragmatic hernia with strangulated loop of bowel presenting after colonoscopy: case report.
作者信息
Sodhi Sandeep S, Zech Loren A, Batura Vijay, Kulasekhar Sampath
机构信息
College of Medicine, University of Illinois at Urbana-Champaign, 190 Medical Sciences Building, 506 South Matthews Ave, Urbana, IL 61801, USA.
出版信息
Int Arch Med. 2009 Dec 11;2(1):38. doi: 10.1186/1755-7682-2-38.
BACKGROUND
The incidence of diaphragmatic hernias caused or exacerbated by diagnostic colonoscopy is not well elucidated at this time, and is believed to be very rare.
CASE PRESENTATION
We present the case of a 57 year old man with remote history of traumatic injury who first presented with vague left shoulder pain for two weeks, mild anemia, and tested positive for fecal occult blood. Four days post colonoscopy the patient was found to have a strangulated loop of bowel herniated through the diaphragm into the left hemithorax.
CONCLUSIONS
In patients with previous history of serious traumatic injury and particularly those with previous splenectomy, a thorough history and physical examination before routine colonoscopy is important. A high level of suspicion for post-operative complications should also be maintained when assessing such patients.
背景
目前，由诊断性结肠镜检查引起或加重的膈疝发病率尚未得到充分阐明，且被认为非常罕见。
病例报告
我们报告一例57岁男性患者，有陈旧性外伤史，最初表现为持续两周的左肩部隐痛、轻度贫血，粪便潜血试验呈阳性。结肠镜检查后四天，发现患者有一段肠管绞窄，经膈肌疝入左胸腔。
结论
对于有严重外伤史的患者，尤其是既往行脾切除术的患者，在进行常规结肠镜检查前进行全面的病史询问和体格检查非常重要。在评估此类患者时，也应高度怀疑术后并发症。
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