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结肠镜检查后脾损伤所致休克

Shock due to Splenic Injury after Colonoscopy.

作者信息

Nallayici Erol G, de Groot Reinier, van Zanten René A A, Lutke Holzik Martijn F

机构信息

aDepartment of Surgery, Ziekenhuisgroep Twente (ZGT), Almelo, the Netherlands.

bDepartment of Gastroenterology, Ziekenhuisgroep Twente (ZGT), Almelo, the Netherlands.

出版信息

Case Rep Gastroenterol. 2017 Mar 3;11(1):127-133. doi: 10.1159/000455940. eCollection 2017 Jan-Apr.

Abstract

Colonoscopy is a common and increasingly performed procedure. It is used both as a diagnostic and therapeutic modality. Splenic injury after colonoscopy is a rare, yet life-threatening complication, most often caused by traction on the splenocolic ligament or excessive manipulation during the procedure. Although non-operative treatment is preferred upon splenic injury, early surgical or radiological intervention may be necessary in specific cases, for example in case of haemodynamic instability. A 71-year-old Caucasian man was referred to our emergency room due to shock after colonoscopy 2 days earlier. A computed tomography scan showed splenic rupture with active intra-abdominal, venous blood loss, and microperforation of the colon. An immediate splenectomy and colon repair were performed through laparotomy. After 6 days, the patient was discharged from hospital in good health. Although splenic rupture is a rare complication of colonoscopy, patients with abdominal pain and/or shock should be checked for complications such as splenic injury and colon perforation.

摘要

结肠镜检查是一种常见且实施越来越多的检查方法。它既用作诊断手段,也用作治疗手段。结肠镜检查后发生脾损伤是一种罕见但危及生命的并发症,最常见的原因是牵拉脾结肠韧带或检查过程中过度操作。尽管脾损伤时首选非手术治疗,但在特定情况下,如血流动力学不稳定时,可能需要早期手术或放射学干预。一名71岁的白种男性在两天前结肠镜检查后因休克被转诊至我们的急诊室。计算机断层扫描显示脾破裂伴有腹腔内活动性静脉失血以及结肠微穿孔。通过剖腹手术立即进行了脾切除术和结肠修复。6天后,患者健康出院。尽管脾破裂是结肠镜检查的罕见并发症,但对于有腹痛和/或休克的患者,应检查是否存在脾损伤和结肠穿孔等并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f1/5465718/81ae4294825a/crg-0011-0127-g01.jpg

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