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全球首例爱尔兰籍且世界第十例因耻骨上导尿继发小肠梗阻的病例。耻骨上导尿罕见并发症的病例报告及病例回顾。

First Irish and tenth case of small bowel obstruction secondary to suprapubic catheterisation in the world. Case report and case review of a rare complication of suprapubic catheterisation.

作者信息

Bashir Yasir, Ain Quart Ul, Jouda Muhammad, Al Sahaf Osama

机构信息

Professorial Surgical Unit, Department of Surgery, The University of Dublin Trinity College, Tallaght Hospital, Dublin, Ireland.

Department of Surgery, Naas General Hospital, County Kildare, Ireland.

出版信息

Int J Surg Case Rep. 2017;41:50-56. doi: 10.1016/j.ijscr.2017.10.005. Epub 2017 Oct 10.

Abstract

INTRODUCTION

Percutaneous Suprapubic urinary bladder catheterisation (SPC) is a common procedure performed in cases of urinary retention where attempt to pass urethral catheter has failed. However, the procedure requires meticulous precision, vigilance and sound knowledge of anatomy, to avoid grave complications. We are reporting a very rare complication of Suprapubic catheterisation that is small bowel obstruction. Our case is first Irish and 10th global case of small bowel obstruction secondary to SPC.

CASE PRESENTATION

Aim of this study was to report this rare complication of the SPC in our patient who was 88 years old retired farmer presenting to emergency department with small bowel obstruction. In our case after clinical examination diagnosis was made with CT scan. Laparoscopy done and found that SPC passed through mesentery before entering bladder and was released laparoscopically. We also searched the literature to find similar reported cases to extract useful information from these cases and use this information to draw conclusions and make recommendations to avoid injuries in the future. Database search conducted in March 2017 on the bibliographic databases Ovid MEDLINE (1946 to November 2016) and EMBASE (1980 to November 2016) along with additional reference searching revealed only 9 reported cases of small bowel obstruction secondary to SPC.

CONCLUSIONS

From the extensive literature search we found that there are only nine cases reported so far globally, and our case is first Irish and tenth international case of bowel obstruction secondary to SPC. Significantly distended bladder, use of ultrasound and extra precaution in elderly patients can reduce the risk of damage to bowel.

摘要

引言

经皮耻骨上膀胱造瘘术(SPC)是在导尿失败的尿潴留病例中进行的常见操作。然而,该操作需要精确细致、警惕以及扎实的解剖学知识,以避免严重并发症。我们报告了一例极为罕见的耻骨上膀胱造瘘术并发症,即小肠梗阻。我们的病例是爱尔兰首例,也是全球第十例继发于耻骨上膀胱造瘘术的小肠梗阻病例。

病例介绍

本研究的目的是报告在我们这位88岁的退休农民患者中发生的这种罕见的耻骨上膀胱造瘘术并发症,该患者因小肠梗阻就诊于急诊科。在我们的病例中,经临床检查后通过CT扫描做出诊断。进行了腹腔镜检查,发现耻骨上膀胱造瘘管在进入膀胱之前穿过了肠系膜,并通过腹腔镜将其取出。我们还检索了文献以查找类似的报告病例,从这些病例中提取有用信息,并利用这些信息得出结论并提出建议,以避免未来的损伤。2017年3月在书目数据库Ovid MEDLINE(1946年至2016年11月)和EMBASE(1980年至2016年11月)上进行的数据库搜索以及额外的参考文献搜索仅发现9例继发于耻骨上膀胱造瘘术的小肠梗阻报告病例。

结论

通过广泛的文献检索,我们发现全球迄今仅报告了9例病例,我们的病例是爱尔兰首例,也是国际上第十例继发于耻骨上膀胱造瘘术的肠梗阻病例。膀胱明显扩张、使用超声以及对老年患者格外谨慎可以降低肠道受损的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b4b/5645488/baa9f62469b4/gr1.jpg

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