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[肾移植患者的结肠穿孔]

[Colonic perforation in patients with kidney transplant].

作者信息

Morcillo Rodenas M A, García Espinosa R, Moliner Quiles C, Pallardo Mateu L, Planells Roig M, Rodero Rodero D

机构信息

Servicio de Cirugía del Aparato Digestivo, Hospital La Fe, Valencia.

出版信息

Rev Esp Enferm Dig. 1990 Jan;77(1):49-51.

PMID:2334585
Abstract

Of a total of 320 renal transplants performed at our center in the last 8 years, two patients presented colonic perforation (0.62%). We emphasize the clinical manifestations, which were masked by the antiinflammatory properties of the steroids; for this reason, careful and repeated physical exams should be made out in the case of any episode of abdominal pain in these patients, as well as ancillary studies for early diagnosis. Surgical measures, which consist of exclusion of the septic focus in the peritoneal cavity, do not differ from those carried out in the general population with the same colonic pathology, although they require more cautious maneuvers and meticulous lavage of the peritoneal cavity. Alternatively, when exclusion is not possible, proximal colostomy and adequate drainage must be performed.

摘要

在过去8年里,我们中心共进行了320例肾移植手术,其中两名患者出现了结肠穿孔(0.62%)。我们强调其临床表现,这些表现被类固醇的抗炎特性所掩盖;因此,对于这些患者出现的任何腹痛发作,都应进行仔细且反复的体格检查,以及用于早期诊断的辅助检查。手术措施包括排除腹腔内的感染源,这与针对具有相同结肠病变的普通人群所采取的措施并无不同,尽管它们需要更谨慎的操作和对腹腔进行细致的冲洗。或者,当无法排除时,必须进行近端结肠造口术并充分引流。

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