Munis Assad, Solomon Brad, Mazulis Andrew, Laurie Timothy
Department of Internal Medicine, Advocate Lutheran General Hospital, Park Ridge, IL.
Division of Gastroenterology, Advocate Lutheran General Hospital, Park Ridge, IL.
ACG Case Rep J. 2018 Sep 26;5:e67. doi: 10.14309/crj.2018.67. eCollection 2018.
Pancreaticoduodenectomy, or Whipple procedure, is a high-risk surgical procedure commonly performed for tumors of the pancreatic head. The pancreatico-enteric anastomosis is an important component of this procedure. The maturation and adequate healing of this anastomotic site is critical to decrease the risk of postoperative pancreatic fistulas. The use of stents can help in the healing of this anastomotic site. We present a patient with pancreatic adenocarcinoma who underwent pancreaticoduodenectomy, and presented with progressively worsening lumbar pain 7 years later. The patient was found to have osteomyelitis as a complication from an entero-spinal fistula secondary to a migrated pediatric feeding tube that was placed at the pancreaticojejunal anastomosis.
胰十二指肠切除术,即惠普尔手术,是一种常用于治疗胰头肿瘤的高风险外科手术。胰肠吻合术是该手术的重要组成部分。此吻合口部位的成熟和充分愈合对于降低术后胰瘘风险至关重要。使用支架有助于该吻合口部位的愈合。我们报告一例患有胰腺腺癌的患者,其接受了胰十二指肠切除术,7年后出现进行性加重的腰痛。该患者被发现患有骨髓炎,这是由于放置在胰空肠吻合口处的儿童喂养管移位继发肠-脊柱瘘引起的并发症。