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腹膜透析导管所致直肠迟发性穿孔的内镜治疗

Endoscopic management of delayed perforation of the rectum caused by a peritoneal dialysis catheter.

作者信息

Baek Seong Kyu, Bae Ok Suk, Jang Byoung Kuk

机构信息

Department of Surgery, Keimyung University Dong-San Medical Center, Jung-Gu, Daegu, Republic of Korea.

出版信息

Surg Laparosc Endosc Percutan Tech. 2011 Feb;21(1):e44-7. doi: 10.1097/SLE.0b013e3182093fb4.

Abstract

Bowel perforation caused by a peritoneal dialysis (PD) catheter is an uncommon complication. It occurs mostly at the time of insertion of a catheter. Delayed perforation of the bowel by a PD catheter can also occur, but is even more uncommon. The ideal management of perforation of the colon by a PD catheter remains to be established because of its very low incidence. Definite surgery is the usual treatment. Here, we report on a 50-year-old male patient who presented with severe watery diarrhea owing to delayed rectal perforation caused by a PD catheter. A computed tomography scan revealed that the catheter tip was inside the lumen of the rectum. This was further confirmed by colonoscopy after bowel preparation. The PD catheter was removed via the original abdominal incision and the rectal perforation was closed using 3 endoscopic clips. The patient made an uneventful recovery.

摘要

腹膜透析(PD)导管引起的肠穿孔是一种罕见的并发症。它大多发生在导管插入时。PD导管导致的肠延迟穿孔也可能发生,但更为罕见。由于其发病率极低,PD导管所致结肠穿孔的理想治疗方法仍有待确定。确定性手术是常用的治疗方法。在此,我们报告一名50岁男性患者,因PD导管导致直肠延迟穿孔出现严重水样腹泻。计算机断层扫描显示导管尖端位于直肠腔内。肠道准备后通过结肠镜检查进一步证实了这一点。通过原腹部切口取出PD导管,并使用3个内镜夹封闭直肠穿孔。患者恢复顺利。

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