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经肛门纱布填塞治疗直肠吻合口漏致骶前脓肿继发的大量骶前出血：一种新方法。

Transanal gauze packing to manage massive presacral bleeding secondary to prescral abscess caused by rectal anastomotic leakage: a novel approach.

作者信息

Yoo Byung-Eun, Lee Dong-Won, Lee Seung-Won, Kwak Jung-Myun, Kim Jin, Kim Seon-Hahn

机构信息

Colorectal Division, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.

出版信息

Ann Surg Treat Res. 2015 Apr;88(4):236-9. doi: 10.4174/astr.2015.88.4.236. Epub 2015 Mar 26.

DOI:10.4174/astr.2015.88.4.236
PMID:25844360
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4384289/
Abstract

Anastomotic leakage following rectal resection is a serious and fearful complication, and may cause presacral abscess and/or peritonitis. To our knowledge, massive hematochezia secondary to presacral abscess caused by anastomotic leakage has not yet been reported in the literature. We observed this rare and life-threatening complication in three patients who were successfully treated with a simple but effective transanal gauze packing technique.

摘要

直肠切除术后吻合口漏是一种严重且可怕的并发症，可能导致骶前脓肿和/或腹膜炎。据我们所知，文献中尚未报道过因吻合口漏引起的骶前脓肿继发大量便血的情况。我们在三名患者中观察到了这种罕见且危及生命的并发症，他们通过一种简单但有效的经肛门纱布填塞技术成功得到了治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74d1/4384289/a4ff5072b8cd/astr-88-236-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74d1/4384289/8205a5aa4b5e/astr-88-236-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74d1/4384289/a96beb571794/astr-88-236-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74d1/4384289/51d480d4935d/astr-88-236-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74d1/4384289/ebb16f7b4a6b/astr-88-236-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74d1/4384289/7744149e5392/astr-88-236-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74d1/4384289/a4ff5072b8cd/astr-88-236-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74d1/4384289/8205a5aa4b5e/astr-88-236-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74d1/4384289/a96beb571794/astr-88-236-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74d1/4384289/51d480d4935d/astr-88-236-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74d1/4384289/ebb16f7b4a6b/astr-88-236-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74d1/4384289/7744149e5392/astr-88-236-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74d1/4384289/a4ff5072b8cd/astr-88-236-g006.jpg

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本文引用的文献

1
Control of presacral venous bleeding during rectal surgery.直肠手术中骶前静脉出血的控制。
Am J Surg. 2010 Aug;200(2):e33-5. doi: 10.1016/j.amjsurg.2009.11.011. Epub 2010 Apr 21.
2
Delayed massive hemorrhage after pancreatic and biliary surgery: embolization or surgery?胰腺和胆道手术后的延迟性大出血：栓塞治疗还是手术治疗？
Ann Surg. 2005 Jan;241(1):85-91. doi: 10.1097/01.sla.0000150169.22834.13.
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New concepts in severe presacral hemorrhage during proctectomy.直肠切除术中严重骶前出血的新概念。
Arch Surg. 1985 Sep;120(9):1013-20. doi: 10.1001/archsurg.1985.01390330025005.
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The use of thumbtacks to stop massive presacral hemorrhage.使用图钉来止住巨大的骶前出血。
Dis Colon Rectum. 1986 Sep;29(9):589-90. doi: 10.1007/BF02554267.
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Efficacy of pelvic packing in maintaining hemostasis after rectal excision for cancer.盆腔填塞在直肠癌切除术后维持止血中的疗效。
Dis Colon Rectum. 1988 Dec;31(12):923-8. doi: 10.1007/BF02554887.
6
Risk of peritonitis and fatal septicaemia and the need to defunction the low anastomosis.腹膜炎和致命性败血症的风险以及低位吻合口去功能化的必要性。
Br J Surg. 1991 Feb;78(2):196-8. doi: 10.1002/bjs.1800780221.