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子宫内避孕器绝育术后并发小肠梗阻和穿孔:病例报告。

Small bowel obstruction and perforation after Essure sterilization: a case report.

机构信息

Department of Surgery, Martini Hospital Groningen, 9728 NT Groningen, The Netherlands.

出版信息

Contraception. 2013 Jan;87(1):121-3. doi: 10.1016/j.contraception.2012.07.007. Epub 2012 Sep 10.

Abstract

BACKGROUND

We present a rare but serious complication of Essure microinsert sterilization.

STUDY DESIGN

Case report.

RESULTS

A 42-year-old woman presented with nausea, vomiting, abdominal pain and abdominal distension 1 month after uncomplicated Essure sterilization. Abdominal X-ray showed small bowel obstruction. At subsequent laparotomy, a stretched Essure device was found ensnaring the terminal ileum. It had caused strangulation and local perforation of the bowel wall. The device was removed and an ileocecal resection with side-to-side ileocolostomy was performed. In retrospect, the aberrant location of the right Essure device near the ileocecal junction was noticed on the abdominal X-ray.

CONCLUSIONS

This case illustrates that perforation of an Essure device can result in a serious complication leading to ileocecal resection. An abdominal X-ray with specific attention to the correct location of the Essure coils is advisable for patients presenting with small bowel obstruction after Essure sterilization.

摘要

背景

我们报告一例 Essure 微植入绝育后罕见但严重的并发症。

研究设计

病例报告。

结果

一位 42 岁女性在 Essure 绝育后 1 个月出现恶心、呕吐、腹痛和腹胀。腹部 X 线片显示小肠梗阻。随后行剖腹术,发现 Essure 装置拉伸后缠绕回肠末端。这导致肠壁的绞窄和局部穿孔。取出装置后,行回肠末端与结肠侧侧吻合术。回顾性分析发现,腹部 X 线片上 Essure 装置的右侧异常位置靠近回盲部交界处。

结论

本例说明 Essure 装置穿孔可导致严重并发症,导致回盲部切除。对于 Essure 绝育后出现小肠梗阻的患者,建议进行 X 线检查,并特别注意 Essure 线圈的正确位置。

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