Chen Hsuan, Hong Mun-Kun, Ding Dah-Ching
Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan; Department of Pathology, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan.
Department of Obstetrics and Gynecology, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan; Department of Pathology, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan; Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
Taiwan J Obstet Gynecol. 2017 Apr;56(2):247-249. doi: 10.1016/j.tjog.2016.03.008.
To report a case of small bowel obstruction caused by barbed suture applied in hysterosacropexy, and possible solutions.
A 57-year-old woman underwent laparoscopic hysterosacropexy for a Stage 2 uterine prolapse, presenting with acute abdominal pain and a bowel obstruction syndrome 2 days following the surgery. Conservative treatment was given, but the symptoms did not improve and gradually became worse. Diagnostic laparoscopy was performed on the 7 day after the hysterosacropexy, and the volvulus was found. The residual end of the barbed V-Loc adopted in the peritoneal closure was incidentally hooked to the mesentery and caused small bowel obstruction. The redundant V-Loc was released and cut off at 2 cm. Neither bowel ischemia nor significant bowel injury was noted. Two days later, she was discharged without complication.
A barbed suture has a risk of bowel obstruction when used in surgery. To avoid a grave prognosis, early diagnosis and prompt management of complication is necessary.
报告1例子宫骶骨固定术中应用倒刺缝线导致小肠梗阻的病例及可能的解决方法。
一名57岁女性因Ⅱ度子宫脱垂接受腹腔镜子宫骶骨固定术，术后2天出现急性腹痛和肠梗阻综合征。给予保守治疗，但症状未改善且逐渐加重。子宫骶骨固定术后第7天行诊断性腹腔镜检查，发现肠扭转。腹膜关闭时采用的倒刺V-Loc缝线残端意外钩住肠系膜，导致小肠梗阻。将多余的V-Loc缝线在距其2 cm处松解并剪断。未发现肠缺血及明显的肠损伤。两天后，患者无并发症出院。
倒刺缝线用于手术时有导致肠梗阻的风险。为避免严重预后，必须对并发症进行早期诊断和及时处理。
