Prakash Ravi, Gupta Digant, Vashi Pankaj
Department of Gastroenterology, Cancer Treatment Centers of America at Midwestern Regional Medical Center, Zion, IL.
ACG Case Rep J. 2017 May 10;4:e65. doi: 10.14309/crj.2017.65. eCollection 2017.
We report a unique case of a 79-year-old woman with metastatic rectal cancer who developed bowel obstruction following endoscopic cryotherapy with liquid nitrogen for palliation of bleeding in the rectum. She developed abdominal distention and pain following the procedure. Computed tomography of the abdomen revealed a paraumbilical hernia containing a segment of transverse colon resulting in partial bowel obstruction. It appears that the recurrent freeze-thaw cycles with poor decompression of the colon despite active venting suction during cryotherapy may have resulted in bowel distention and collapse, causing conformational changes resulting in partial bowel obstruction due to a paraumbilical hernia.
我们报告了一例独特的病例，一名79岁患有转移性直肠癌的女性，在接受液氮内镜冷冻治疗以缓解直肠出血后发生了肠梗阻。术后她出现了腹胀和疼痛。腹部计算机断层扫描显示脐旁疝，其中包含一段横结肠，导致部分肠梗阻。看来，尽管在冷冻治疗期间进行了积极的排气抽吸，但反复的冻融循环且结肠减压不佳，可能导致了肠扩张和塌陷，引起结构变化，进而因脐旁疝导致部分肠梗阻。
