Hayashi Hironori, Takamura Hiroyuki, Ohbatake Yoshinao, Shoji Masatoshi, Nakanuma Shin-Ichi, Nakagawara Hisatoshi, Miyashita Tomoharu, Tajima Hidehiro, Kitagawa Hirohisa, Tani Takashi, Shimizu Koichi, Ohta Tetsuo
Department of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan.
Case Rep Surg. 2013;2013:923647. doi: 10.1155/2013/923647. Epub 2013 Sep 12.
Biliary complications have great importance for liver transplant recipients because of affecting long-term prognosis. In rare situations, an internal hernia of the Roux-en-Y loop cause graft injury. A 42-year-old woman with a history of living donor liver transplantation 6 years ago presented with prolonged graft injury during the past 6 months. She suddenly developed ileus of the small bowel with internal hernia through the defect of the mesentery around the Roux-en-Y limb of the hepaticojejunostomy. Emergent surgery was performed to reduce the hernia and volvulus; also the mesenteric rent was closed with interrupted suture of silk. Internal hernia of the small bowel after liver transplantation is rare but causes graft injury due to associated biliary complications and rapid deterioration of patient's condition.
胆道并发症对肝移植受者非常重要,因为它会影响长期预后。在罕见情况下,Roux-en-Y袢内疝会导致移植物损伤。一名42岁女性,6年前有活体供肝肝移植史,在过去6个月出现移植物长期损伤。她突然出现小肠肠梗阻,通过肝空肠吻合术Roux-en-Y袢周围肠系膜缺损形成内疝。急诊手术进行了疝复位和肠扭转复位;同时用丝线间断缝合关闭肠系膜裂孔。肝移植后小肠内疝罕见,但由于相关的胆道并发症和患者病情迅速恶化会导致移植物损伤。