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一名因肾上腺髓样脂肪瘤而被诊断为胸骨切开术后肝疝的患者,通过两周等待期转诊。

A 2-week wait referral diagnosed with post-sternotomy liver herniation in a background of adrenal myelolipoma.

作者信息

Oyewole Bankole, Boshnaq Mohamed, Yaktien Mohammed, Ahmed Shabbir

机构信息

Department of General Surgery, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK.

Department of Radiology, Queen Elizabeth Queen Mother Hospital, Margate, UK.

出版信息

BMJ Case Rep. 2019 Jul 26;12(7):e230594. doi: 10.1136/bcr-2019-230594.

Abstract

Herniation of the liver through the anterior abdominal wall is a rare post-sternotomy complication. A 32-year-old woman had a 2-week wait referral due to abdominal pain, weight loss and upper abdominal swelling. She was known to have a left adrenal myelolipoma and had a mitral valve replacement 3 years prior to presentation with the postoperative period complicated by sepsis and poor wound healing. She had recently been started on metformin for type 2 diabetes mellitus and she had long-standing lower abdominal symptoms known to the gynaecology team. Investigations revealed hepatic herniation of liver segments II & III through the anterior abdominal wall while there was no underlying malignancy a benign left adrenal myelolipoma was noted.

摘要

肝脏经前腹壁疝出是一种罕见的胸骨切开术后并发症。一名32岁女性因腹痛、体重减轻和上腹部肿胀,等待了两周才就诊。已知她患有左肾上腺髓质脂肪瘤,在此次就诊前3年进行了二尖瓣置换术,术后出现败血症和伤口愈合不良的并发症。她最近开始服用二甲双胍治疗2型糖尿病,妇科团队知晓她有长期的下腹部症状。检查发现肝段II和III经前腹壁发生肝脏疝出,未发现潜在恶性肿瘤,但发现了一个良性的左肾上腺髓质脂肪瘤。

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