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腹股沟管内遗留手术物品:一例病例报告及文献综述

Retained Surgical Items in Inguinal Canal: A Case Report and Literature Review.

作者信息

Al Ani Amer Hashim, Hammami Mohammad Bakri, Adi Obaidah M Mukhles

机构信息

Department of General Surgery, Sheikh Khalifa Medical City, Ajman, United Arab Emirates.

College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.

出版信息

Open Access Maced J Med Sci. 2018 Nov 23;6(11):2165-2167. doi: 10.3889/oamjms.2018.377. eCollection 2018 Nov 25.

Abstract

BACKGROUND

Retained surgical items (RSI) are rare medical challenges with serious complications and medicolegal implications. Knowledge and preventive measures for these rare events are currently not sufficient to limit their increasing incidence. Gauzes and sponges constitute most of RSI. Forceps, needles and pins may be found too. Diagnosis of these events is challenging and often missed due to nonspecific clinical findings.

PRESENTATION OF CASE

We present here a 49-year-old patient who presented to the clinic with a history of chronic scrotal sinus on the same side of a repeatedly repaired inguinal hernia 4 months before admission. He underwent exploration of the inguinal canal as elective surgery. Exploration of the inguinal canal revealed missed surgical gauze left during the previous hernia repair. The gauze was removed, and the inguinal canal was repaired. The postoperative period was uncomplicated.

CONCLUSION

Retained surgical items are completely preventable near-events. Although they are rare entities, clinicians must have a high index of suspicion for any postoperative, in patients presenting with pain, sinus or palpable masses.

摘要

背景

手术遗留物品(RSI)是罕见的医疗难题,会引发严重并发症并涉及法医学问题。目前,针对这些罕见事件的认知和预防措施尚不足以限制其发病率的上升。纱布和海绵占手术遗留物品的大部分。也可能会发现镊子、针和别针。这些事件的诊断具有挑战性,且由于临床表现不具特异性,往往容易漏诊。

病例介绍

我们在此介绍一名49岁的患者,入院前4个月因同侧腹股沟疝反复修补术后出现慢性阴囊窦病史前来就诊。他接受了腹股沟管探查作为择期手术。腹股沟管探查发现上次疝修补术中遗留的手术纱布。取出纱布后,对腹股沟管进行了修补。术后恢复顺利。

结论

手术遗留物品是完全可预防的险些发生的事件。尽管它们是罕见情况,但临床医生对于任何术后出现疼痛、窦道或可触及肿块的患者,都必须保持高度警惕。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/174c/6290442/b28049a71920/OAMJMS-6-2165-g001.jpg

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