Limmer Alexandra M, Clement Zackariah
Department of Surgery, Liverpool Hospital, Liverpool, NSW 2170, Australia.
Case Rep Surg. 2017;2017:1090769. doi: 10.1155/2017/1090769. Epub 2017 Aug 15.
Caecal perforation is a life-threatening complication of large bowel obstruction with a reported mortality of 34% to 72%. This case describes the novel use of percutaneous needle caecostomy as a life-saving measure to prevent imminent caecal perforation in a 68-year-old lady with large bowel obstruction secondary to an incarcerated incisional hernia. After careful review of computed tomography images and measurement of distances from the abdominal wall to the caecum, the patient's caecum was decompressed in the emergency department using a needle under local anaesthetic. The patient subsequently underwent laparoscopic hernia repair and had an uncomplicated recovery. When conducted safely and with precision in an appropriate patient, percutaneous needle caecostomy can provide immediate symptom relief, reduce risk of caecal perforation, and allow a laparoscopic surgical approach.
盲肠穿孔是大肠梗阻的一种危及生命的并发症，据报道死亡率为34%至72%。本病例描述了经皮穿刺盲肠造口术的一种新用途，即作为一种挽救生命的措施，以防止一名68岁患有嵌顿性切口疝继发大肠梗阻的女性即将发生的盲肠穿孔。在仔细查看计算机断层扫描图像并测量从腹壁到盲肠的距离后，在急诊科对患者的盲肠进行局部麻醉下的穿刺减压。患者随后接受了腹腔镜疝修补术，恢复过程顺利。在合适的患者中安全、精确地进行经皮穿刺盲肠造口术，可以立即缓解症状，降低盲肠穿孔的风险，并允许采用腹腔镜手术方法。
