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结肠镜检查期间的脾损伤:腹腔内粘连的作用。

Splenic Trauma during Colonoscopy: The Role of Intra-Abdominal Adhesions.

作者信息

Chime Chukwunonso, Ishak Charbel, Kumar Kishore, Kella Venkata, Chilimuri Sridhar

机构信息

Bronx Care Hospital Health System, Affiliate of Icahn School of Medicine at Mount Sinai, New York, NY, USA.

出版信息

Case Rep Gastrointest Med. 2018 May 15;2018:4879413. doi: 10.1155/2018/4879413. eCollection 2018.

Abstract

Splenic rupture following colonoscopy is rare, first reported in 1974, with incidence of 1-21/100,000. It is critical to anticipate splenic trauma during colonoscopy as one of the causes of abdominal pain after colonoscopy especially when located in the left upper quadrant or left shoulder. Postoperative adhesions is a predisposing factor for splenic injury, and management is either operative or nonoperative, based on hemodynamic stability and/or extravasation which can be seen on contrast-enhanced CT scan of the abdomen. We present a case of a splenic rupture after colonoscopy in a patient with splenocolic adhesions, requiring splenectomy as definite treatment.

摘要

结肠镜检查后脾破裂较为罕见,首次报道于1974年,发病率为1 - 21/10万。在结肠镜检查期间预测脾损伤至关重要,这是结肠镜检查后腹痛的原因之一,尤其是当腹痛位于左上腹或左肩时。术后粘连是脾损伤的一个诱发因素,治疗方法根据血流动力学稳定性和/或腹部增强CT扫描可见的外渗情况,可选择手术或非手术治疗。我们报告一例结肠镜检查后脾破裂的病例,该患者存在脾结肠粘连,最终需要行脾切除术作为确定性治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10c2/5976928/5032345903be/CRIGM2018-4879413.001.jpg

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