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造口旁迟发性肠脱出。

Late parastomal evisceration.

机构信息

Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain.

出版信息

Int J Colorectal Dis. 2020 Sep;35(9):1787-1789. doi: 10.1007/s00384-020-03628-5. Epub 2020 May 25.

Abstract

BACKGROUND

Parastomal evisceration is a very uncommon complication of stomas with only few cases reported in the literature. This complication can be developed in the early postoperative period due to technical aspects of stoma creation, but late parastomal evisceration appearing after 6 months from surgery is an exceptional condition. Herein, we present a rare case of a patient with late parastomal evisceration.

CASE PRESENTATION

A 44-year-old man with sigmoid volvulus underwent a temporary end-terminal colostomy. The ostomy was complicated by a parastomal hernia and stoma prolapse 5 months postoperatively. He was brought into our emergency department having been found collapsed in the street. On physical examination, the patient presented signs of shock and evisceration of small bowel through the colostomy. Intraoperatively, a perforation of prolapsed colon was assessed as the point for intestinal evisceration. We discuss this case and all similar cases reported in the literature.

CONCLUSION

Parastomal evisceration is a potentially life-threatening complication. Patients with parastomal hernia and stoma prolapse must be considered for surgical treatment to avoid this complication.

摘要

背景

肠造口旁疝是一种非常罕见的造口并发症,文献中仅有少数病例报道。这种并发症可能由于造口技术方面的原因在术后早期发生,但术后 6 个月后出现的迟发性肠造口旁疝则是一种特殊情况。本文介绍了一例迟发性肠造口旁疝的罕见病例。

病例介绍

一名 44 岁男性因乙状结肠扭转行暂时性末端结肠造口术。术后 5 个月,造口出现肠造口旁疝和造口脱垂,并发造口疝。患者被发现昏倒在街头后被送入我院急诊。体格检查发现患者有休克和小肠通过造口脱出的体征。术中评估脱垂结肠穿孔是肠脱出的原因。我们讨论了这个病例以及文献中所有类似的病例。

结论

肠造口旁疝是一种潜在危及生命的并发症。对于有肠造口旁疝和造口脱垂的患者,必须考虑手术治疗以避免这种并发症。

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