Christensen Jakob Gerlach, Achiam Michael Patrich
Ragnagade 15, 1.1., 2100-København Ø.
Ugeskr Laeger. 2015 Jan 26;177(2A):98-9.
After laparoscopic appendectomy complications and injury to the intraabdominal organs and major vessels are rare but well documented. The majority of complications occur during establishment of pneumoperitoneum. Frequently used entries are open trocar (Hasson), closed using Veress needle and direct trocar insertion. In this case we describe an incident where the towel clip, used to get hold of the supraumbilical fascia to minimize the risk of injury, was pressed down too hard. The retroperitoneum was accidentally punctured and a haematoma above vena cava was created.
腹腔镜阑尾切除术后,腹腔内器官和大血管的并发症及损伤虽罕见但有充分记录。大多数并发症发生在建立气腹过程中。常用的穿刺方法有开放套管针(哈森法)、使用韦雷氏针闭合穿刺法和直接套管针插入法。在本病例中,我们描述了这样一个事件:为降低损伤风险而用于固定脐上筋膜的巾钳被按压过用力,意外穿刺了腹膜后腔并在腔静脉上方形成了血肿。