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本文引用的文献

1
Complications of adjustable gastric banding.可调胃束带术的并发症。
Surg Clin North Am. 2011 Dec;91(6):1249-64, ix. doi: 10.1016/j.suc.2011.08.008.
2
Death-related gastric necrosis after laparoscopic adjustable gastric banding in the early post-operative period.术后早期腹腔镜可调节胃束带术相关胃坏死致死亡。
Diagn Pathol. 2010 Oct 11;5:68. doi: 10.1186/1746-1596-5-68.
3
Long-term results and complications following adjustable gastric banding.可调胃束带术的长期结果和并发症。
Obes Surg. 2010 Aug;20(8):1078-85. doi: 10.1007/s11695-010-0190-3.
4
Gastric necrosis: a rare complication of gastric banding.胃坏死：胃束带术的一种罕见并发症。
Obes Surg. 2005 Sep;15(8):1211-4. doi: 10.1381/0960892055002194.
5
Late gastric prolapse with pouch necrosis after laparoscopic adjustable gastric banding.腹腔镜可调节胃束带术后迟发性胃脱垂伴胃囊坏死
Obes Surg. 2005 Apr;15(4):571-5. doi: 10.1381/0960892053723420.
6
Complications of gastric banding presenting to the ED.胃束带术并发症在急诊科的表现。
Am J Emerg Med. 2005 May;23(3):368-70. doi: 10.1016/j.ajem.2005.02.016.

急性胃束带滑脱伴胃坏死及大量出血。

Acutely slipped gastric band with gastric necrosis and massive haemorrhage.

作者信息

Parys Simon, Werapitiya Senarath

机构信息

Department of General Surgery, Bunbury Regional Hospital, Bunbury, Australia

Department of General Surgery, Bunbury Regional Hospital, Bunbury, Australia.

出版信息

J Surg Case Rep. 2013 Aug 29;2013(8):rjt053. doi: 10.1093/jscr/rjt053.

DOI:10.1093/jscr/rjt053
PMID:24964464
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3813746/
Abstract

We present a case of acute gastric band slippage with gastric necrosis and massive haemoperitoneum necessitating an emergency surgery. The patient presented with an 8h history of dysphagia, vomiting and epigastric pain. Initial examination was unremarkable, but within 6h the patient suddenly deteriorated with a distended peritonitic abdomen. At laparotomy the patient was found to have gastric band slippage, a distended necrotic gastric pouch, a denuded spleen and a massive intraperitoneal haemorrhage of approximately 4l. A splenectomy was performed to control haemorrhage and sleeve gastrectomy to remove the necrotic pouch. The patient made an uneventful recovery. There are no reported cases of massive intraperitoneal haemorrhage or splenic involvement in cases of gastric band slippage. We believe that the gastric necrosis lead to short gastric and splenic vein thrombus and splenic outflow obstruction. This resulted in a subcapsular haematoma which subsequently ruptured causing acute deterioration.

摘要

我们报告一例急性胃束带滑脱伴胃坏死及大量腹腔内出血，需行急诊手术。患者出现吞咽困难、呕吐和上腹部疼痛8小时病史。初始检查无异常，但6小时内患者突然病情恶化，出现腹胀伴腹膜炎体征。剖腹手术时发现患者存在胃束带滑脱、扩张坏死的胃囊、裸露的脾脏以及约4升的大量腹腔内出血。行脾切除术以控制出血，并进行袖状胃切除术以切除坏死的胃囊。患者恢复顺利。文献中尚无胃束带滑脱病例出现大量腹腔内出血或脾脏受累的报道。我们认为胃坏死导致胃短血管和脾静脉血栓形成以及脾血流梗阻。这导致了脾包膜下血肿，随后破裂，引起急性病情恶化。