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膈疝作为结肠镜检查的罕见并发症:病例报告及文献复习

Diaphragmatic hernia as a rare complication of colonoscopy: Case report and literature review.

作者信息

Liu Siyu, Dai Mugen, Ye Bin, Zhao Zhigang, Shi Yang, Peng Lirong

机构信息

Department of Medicine Department of Gastroenterology Department of Laboratory medicine, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang Province, China.

出版信息

Medicine (Baltimore). 2018 Jan;97(3):e9660. doi: 10.1097/MD.0000000000009660.

Abstract

RATIONALE

Diaphragmatic Hernia is rare as complication of Colonoscopy. Diaphragmatic hernia as a complication of colonoscopy has been reported only few cases. Additionally, it is often misdiagnosed as other disease by clinicians due to their lack of related knowledge, which delays diagnosis of Diaphragmatic hernia and thus exacerbates the prognosis.

PATIENT CONCERNS

We report the case of a 66-year-old man with fecal occult blood. In the case, sudden epigastric pain after colonoscopy owing to diaphragmatic hernia in a left hemidiaphragm.

DIAGNOSES

The diagnoses made by a CT scan without delay. It showed marked protrusion of the large bowel into the left thoracic cavity along with elevation of the left diaphragm.

INTERVENTIONS

The diaphragmatic defect was repaired by simple closure and intestinal adhesions release surgery.

OUTCOMES

Five days after surgery, the patient was discharged in good condition.

LESSONS

Most of diaphragmatic hernia is congenital with high mortality. However, there are a few cases of Diaphragmatic hernia caused by previous trauma or surgery. We herein report an unusual case of diaphragmatic hernia related to colonoscopy but usually life-threatening complication.

摘要

理论依据

膈疝作为结肠镜检查的并发症较为罕见。仅报道过少数几例结肠镜检查并发膈疝的病例。此外,由于临床医生缺乏相关知识,该病常被误诊为其他疾病,从而延误膈疝的诊断,进而使预后恶化。

患者情况

我们报告一例66岁大便潜血男性患者的病例。该病例中,患者在结肠镜检查后因左侧半膈肌出现膈疝而突发上腹部疼痛。

诊断

通过CT扫描及时做出诊断。结果显示大肠明显突入左胸腔,同时左侧膈肌抬高。

干预措施

通过简单缝合修复膈肌缺损并进行肠粘连松解手术。

结果

术后5天,患者康复出院。

经验教训

大多数膈疝是先天性的,死亡率较高。然而,也有少数膈疝病例是由既往创伤或手术引起的。我们在此报告一例与结肠镜检查相关的罕见膈疝病例,但其通常是危及生命的并发症。

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