Saint Joseph Mercy Hospital Ann Arbor, Ann Arbor, Michigan.
Center for Colon and Rectal Surgery, Advent Health, Orlando, Florida.
Dis Colon Rectum. 2019 Sep;62(9):1028-1030. doi: 10.1097/DCR.0000000000001441.
An otherwise healthy 59-year-old man presented to the emergency department with 2 weeks of narrowed stools, 5 days of obstipation, and 1 day of abdominal pain, nausea, and vomiting. Computed tomography revealed an obstructing sigmoid mass without evidence of metastatic disease, and the CEA was 1.2 ng/mL. Flexible sigmoidoscopy confirmed a circumferentially obstructing distal sigmoid neoplasm. Endoscopic stent placement was immediately followed by a firm distended abdomen. An upright radiograph obtained following the procedure demonstrated free intraperitoneal air. An emergent Hartmann procedure was performed for iatrogenic colon perforation in a patient with malignant obstruction and chronic dilation of the proximal colon.
一位 59 岁的健康男性，因两周来粪便变细、五天来便秘、一天来腹痛、恶心和呕吐，到急诊就诊。计算机断层扫描显示有一个阻塞性乙状结肠肿块，没有转移疾病的证据，癌胚抗原为 1.2ng/ml。纤维乙状结肠镜检查证实了一个环形阻塞的乙状结肠远端肿瘤。内镜支架置入后立即出现腹胀。在操作后获得的直立射线照片显示有游离的腹腔积气。在一位患有恶性梗阻和近端结肠慢性扩张的患者中，由于医源性结肠穿孔，紧急施行 Hartmann 手术。
