Yu Jing, Zhou Cheng-Ji, Wang Pan, Wei Shou-Jiang, He Jin-Song, Tang Jin
Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.
World J Clin Cases. 2018 Dec 6;6(15):1047-1052. doi: 10.12998/wjcc.v6.i15.1047.
This report describes a 52-year-old male patient with blunt abdominal traumatic rupture of the spleen due to injuries sustained in an automobile accident. Following splenectomy, the patient developed a gastric fistula. He underwent a long period of conservative treatment, including antibiotics and total parenteral nutrition, which was ineffective. The fistula could not be closed and titanium clip closure using a gastroscopy was then performed in order to close the fistula. After endoscopic therapy and clipping surgery, the patient's general condition improved significantly, and he had no post-procedural abdominal complications. On post-clipping day 6, the gastric fistula was completely closed as shown by X-ray examination of the upper digestive tract. The patient was discharged from hospital and no complications were observed during the six-month follow-up period. Our report suggests that titanium clip closure using endoscopy may be the choice of treatment in patients with a gastric fistula.
本报告描述了一名52岁男性患者,因在汽车事故中受伤导致腹部钝性外伤致脾破裂。脾切除术后,患者出现胃瘘。他接受了长时间的保守治疗,包括使用抗生素和全胃肠外营养,但无效。瘘口无法闭合,随后进行了胃镜下钛夹闭合术以闭合瘘口。内镜治疗和夹闭手术后,患者的一般状况明显改善,术后无腹部并发症。夹闭术后第6天,上消化道X线检查显示胃瘘完全闭合。患者出院,在6个月的随访期内未观察到并发症。我们的报告表明,内镜下钛夹闭合术可能是胃瘘患者的治疗选择。