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腹腔镜阑尾切除术后阑尾残端线性切割吻合器所致内疝和小肠梗阻

Internal hernia and small bowel obstruction caused by a linear cutter staple at appendiceal stump following laparoscopic appendectomy.

作者信息

Petersen Lindsay F, Nally Mary C, Agos Andrew, Petty Kyle

机构信息

Department of General Surgery, Rush University Medical Center, Chicago, IL, USA.

Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA

出版信息

J Surg Case Rep. 2014 Jan 15;2014(1):rjt114. doi: 10.1093/jscr/rjt114.

DOI:10.1093/jscr/rjt114
PMID:24876320
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3895141/
Abstract

Commonly linear staplers are used to perform laparoscopic appendectomies. We report a case of a small bowel obstruction caused by a staple on the appendiceal stump creating an internal hernia <1 week after laparoscopic appendectomy. We discuss the available literature on bowel obstructions caused by staples. Most of the discussed complications were caused by staples free in the abdomen, which were remote from the staple line. Generally, loose staples do not cause problems, but if noted during the operation, we recommend removal to prevent future obstruction.

摘要

通常使用线性吻合器进行腹腔镜阑尾切除术。我们报告了一例腹腔镜阑尾切除术后不到1周，阑尾残端的吻合钉导致内疝从而引起小肠梗阻的病例。我们讨论了有关吻合钉引起肠梗阻的现有文献。所讨论的大多数并发症是由腹腔内游离的吻合钉引起的，这些吻合钉远离吻合钉线。一般来说，松动的吻合钉不会引起问题，但如果在手术中发现，我们建议取出以防止未来发生梗阻。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b304/3895141/39cc1023f177/rjt11402.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b304/3895141/67081343e0da/rjt11401.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b304/3895141/39cc1023f177/rjt11402.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b304/3895141/67081343e0da/rjt11401.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b304/3895141/39cc1023f177/rjt11402.jpg

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本文引用的文献

1
The appendiceal stump closure during laparoscopy: historical, surgical, and future perspectives.腹腔镜阑尾残端闭合术：历史、手术及未来展望
Surg Laparosc Endosc Percutan Tech. 2012 Feb;22(1):1-4. doi: 10.1097/SLE.0b013e31823fbf15.
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Retained loose linear cutter staples after laparoscopic appendectomy as the cause of mechanical small bowel obstruction.腹腔镜阑尾切除术后残留松散的线性切割吻合钉致机械性小肠梗阻
Int J Colorectal Dis. 2007 Jun;22(6):717-8. doi: 10.1007/s00384-005-0759-9. Epub 2005 Jun 8.
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Minerva Chir. 2003 Aug;58(4):591-4.
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Mechanical small bowel obstruction from a loose linear cutter staple after laparoscopic appendectomy.腹腔镜阑尾切除术后因松散的线性切割吻合器导致的机械性小肠梗阻。
Surg Laparosc Endosc Percutan Tech. 2002 Aug;12(4):289-90. doi: 10.1097/00129689-200208000-00019.
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