Moreels Tom G, Op de Beeck Bart, Pelckmans Paul A
Case Rep Gastroenterol. 2008 Jul 24;2(2):250-5. doi: 10.1159/000135607.
We present the case of a 77-year-old male who was referred for magnetic resonance (MR) enteroclysis because of small bowel subobstruction. To optimise small bowel distention during MR, a nasojejunal balloon catheter was placed to perfuse iso-osmotic water solution into the small bowel. However, after deflation of the balloon, the catheter could not be removed by gentle traction. Subsequently, computed tomography (CT) of the abdomen revealed that the catheter was strangulated deep in the jejunum and traction resulted in painful backward intussusception of the small bowel. In order to avoid surgical intervention, we decided to perform urgent proximal double-balloon enteroscopy to remove the enteroclysis catheter. Under fluoroscopic guidance, the enteroscope was introduced into the jejunum until the tip of the enteroscope reached the tip of the catheter. By straightening the enteroscope, the catheter could then be retracted from the jejunum, using the enteroscope as a guide wire along the catheter. Urgent surgical intervention was avoided and the patient completely recovered the same day.
我们报告一例77岁男性患者,因小肠不全梗阻而接受磁共振(MR)小肠造影检查。为在MR检查期间优化小肠扩张,放置了一根鼻空肠球囊导管,以便向小肠灌注等渗水溶液。然而,球囊放气后,无法通过轻柔牵拉取出导管。随后,腹部计算机断层扫描(CT)显示导管在空肠深部被绞窄,牵拉导致小肠痛苦地向后套叠。为避免手术干预,我们决定紧急进行近端双气囊小肠镜检查以取出小肠造影导管。在荧光镜引导下,将小肠镜插入空肠,直到小肠镜尖端到达导管尖端。通过伸直小肠镜,然后可以将小肠镜作为沿导管的导丝,将导管从空肠中撤回。避免了紧急手术干预,患者于当天完全康复。