Ozdil Burhan, Yamak Yusuf Ziya, Kece Can, Cebi Kibar
Department of Gastroenterology, Research Hospital, Trabzon, Turkey.
Minim Invasive Ther Allied Technol. 2011 May;20(3):193-6. doi: 10.3109/13645706.2010.518791. Epub 2010 Oct 8.
Postoperative upper gastrointestinal fistulas or anastomotic leaks with peritonitis are rare but serious clinical conditions. Due to severe fluid and electrolyte imbalance and risk of development of sepsis implementation of efficient and timely management is crucial. Various endoscopic interventions have been performed to date for postoperative upper gastrointestinal fistulas. We herein describe a new therapeutical approach involving lipiodol injection, which we performed to treat a patient who had unsuccessfully undergone surgery for a posttraumatic duodenal fistula. The fistula was then successfully managed by endoscopic lipiodol injection. We present this case due to its interesting nature of a postsurgical duodenal fistula without evident fistula tract, and a successful therapy by a new approach, lipiodol injection. We conclude that this new method offers an option for patients with high operation risk or for those with failed surgery, and this new method may decrease morbidity, mortality and the time required for the closure of duodenal fistulas.
术后上消化道瘘或伴有腹膜炎的吻合口漏虽罕见但属于严重的临床病症。由于存在严重的液体和电解质失衡以及发生脓毒症的风险，实施高效且及时的管理至关重要。迄今为止，已针对术后上消化道瘘开展了各种内镜干预措施。我们在此描述一种涉及碘油注射的新治疗方法，我们用此方法治疗了一名因创伤后十二指肠瘘接受手术但未成功的患者。该瘘随后通过内镜碘油注射成功得到处理。我们呈现此病例是因其作为无明显瘘道的术后十二指肠瘘具有有趣的特性，以及通过碘油注射这种新方法成功进行治疗。我们得出结论，这种新方法为手术风险高的患者或手术失败的患者提供了一种选择，并且这种新方法可能降低发病率、死亡率以及十二指肠瘘闭合所需的时间。
