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腹腔镜胆囊切除术后迟发性空肠穿孔

Delayed jejunal perforation after laparoscopic cholecystectomy.

作者信息

Browne Ikennah L, Dixon Elijah

机构信息

Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada Department of General Surgery, Foothills Medical Centre, Calgary, AB, Canada.

Department of General Surgery, Foothills Medical Centre, Calgary, AB, Canada Oncology and Community Health Sciences, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

出版信息

J Surg Case Rep. 2016 Feb 22;2016(2):rjw017. doi: 10.1093/jscr/rjw017.

Abstract

Bowel perforation is a rare complication of laparoscopic cholecystectomy, which if left undiagnosed can have fatal consequences. In addition, isolated small bowel perforation is extremely rare and should be considered in patients presenting with sudden onset abdominal pain in the postoperative period. A 57-year-old male with symptomatic gallstones underwent urgent laparoscopic cholecystectomy and was discharged home on postoperative day (POD) 1 without complications. He presented to the emergency department on POD 11 complaining of sudden onset abdominal pain. A CT scan did not confirm a diagnosis and he was admitted for observation. On post admission day 2, he became significantly peritonitic and laparotomy revealed jejunal perforation. Bowel resection with hand-sewn anastomosis was completed and he was discharged on POD 10. Follow-up at 6 weeks revealed no further issues. We review the literature on small bowel perforation post laparoscopic cholecystectomy.

摘要

肠穿孔是腹腔镜胆囊切除术罕见的并发症,若未被诊断,可能会导致致命后果。此外,孤立性小肠穿孔极为罕见,对于术后突发腹痛的患者应予以考虑。一名57岁有症状胆结石的男性接受了急诊腹腔镜胆囊切除术,术后第1天出院,无并发症。他在术后第11天因突发腹痛就诊于急诊科。CT扫描未确诊,遂住院观察。入院第2天,他出现明显的腹膜炎,剖腹探查发现空肠穿孔。完成肠切除并手工缝合吻合,他于术后第10天出院。6周后的随访未发现进一步问题。我们回顾了腹腔镜胆囊切除术后小肠穿孔的相关文献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f92e/4763165/50228408ef16/rjw01701.jpg

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