Sakamoto Yuki, Hiyoshi Yukiharu, Sakata Kazuya, Toyama Eiichiro, Takata Noboru, Yoshinaka Ichiro, Harada Kazunori, Baba Hideo
Department of Surgery, Amakusa Medical Center, Kumamoto, Japan.
Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Asian J Endosc Surg. 2018 Nov;11(4):402-404. doi: 10.1111/ases.12460. Epub 2018 Jan 11.
We herein report a case of cecal volvulus successfully treated with endoscopic colopexy. A 73-year-old man with a high fever and abdominal fullness was diagnosed with ileus caused by cecal volvulus. CT showed a dilated cecum and small intestine without bowel strangulation as well as acute pneumonia. Because the pneumonia increased the risk associated with general anesthesia, we attempted decompression of the bowel using endoscopy to avoid surgery. On day 1, a transanal ileus tube was inserted to the terminal ileum through the dilated cecum. On day 7, the bowel torsion spontaneously released. On day 8, we performed percutaneous endoscopic colopexy to fix the cecum on the abdominal wall and prevent re-twisting. The patient was discharged on day 15 without postoperative complications. Percutaneous endoscopic colopexy for cecal volvulus may be a treatment option when the risk associated with general anesthesia or surgery is high because of a comorbidity.
我们在此报告一例通过内镜结肠固定术成功治疗的盲肠扭转病例。一名73岁男性,伴有高热和腹胀,被诊断为盲肠扭转引起的肠梗阻。CT显示盲肠和小肠扩张,无肠绞窄,同时伴有急性肺炎。由于肺炎增加了全身麻醉相关风险,我们尝试通过内镜进行肠道减压以避免手术。第1天,经肛门将肠梗阻导管通过扩张的盲肠插入回肠末端。第7天,肠扭转自行解除。第8天,我们进行了经皮内镜结肠固定术,将盲肠固定在腹壁上以防止再次扭转。患者于第15天出院,无术后并发症。对于因合并症导致全身麻醉或手术风险较高的盲肠扭转患者,经皮内镜结肠固定术可能是一种治疗选择。