Ramdwar Noel, Cox Daniel, Aldujaili Thair
Department of General Surgery, Goulburn Valley Health, Graham Street, Shepparton, VIC 3630, Australia.
Department of General Surgery, The Northern Hospital, 185 Cooper Street, Epping, VIC 3076, Australia.
J Surg Case Rep. 2018 May 2;2018(5):rjy086. doi: 10.1093/jscr/rjy086. eCollection 2018 May.
Ileostomy formation is a fundamental component in the surgical management of many gastrointestinal diseases and like all intra-abdominal surgeries, small bowel obstruction is a recognized complication. In this paper we discuss a case of a 44-year-old female who previously had a loop ileostomy for slow bowel transit in the presence of spinal bifida. She presented for subsequent total colectomy because of ongoing pain due to chronic colonic dilation. At surgery, the stoma was not revised and the efferent loop was divided at the peritoneal level of the anterior abdominal wall. Six days postoperatively, the patient developed a small bowel obstruction as a result of the remnant efferent loop within the anterior abdominal wall, forming a cystic mass compressing the ileostomy, requiring surgical intervention. As far as we are aware, this is the first case of small bowel obstruction described due to this unusual etiology.
回肠造口术的形成是许多胃肠道疾病外科治疗的基本组成部分,与所有腹部手术一样,小肠梗阻是一种公认的并发症。在本文中,我们讨论了一例44岁女性病例,该患者之前因脊柱裂导致肠道蠕动缓慢而行袢式回肠造口术。由于慢性结肠扩张持续疼痛,她前来接受后续的全结肠切除术。手术时,未对造口进行修复,在腹前壁腹膜水平处切断传出袢。术后第六天,患者因腹前壁内残留的传出袢形成囊性肿块压迫回肠造口而发生小肠梗阻,需要手术干预。据我们所知,这是首例因这种不寻常病因导致小肠梗阻的病例。