Shinohara Kentaro, Suzuki Masahiko, Asaba Yutaro, Maeta Takao, Ishida Tomoyuki, Mizukami Yasunobu
Department of Surgery, JA Kohseiren Enshu Hospital, Hamamatsu, Japan.
J Surg Case Rep. 2020 Jun 25;2020(6):rjaa124. doi: 10.1093/jscr/rjaa124. eCollection 2020 Jun.
An 81-year-old woman had undergone laparoscopic abdominoperineal resection for rectal cancer. A permanent colostomy was created through an intraperitoneal route. Three months after the surgery, the patient presented with lower abdominal pain and vomiting. Computed tomography showed gastric incarceration through the lateral space of the lifted sigmoid colostomy. Although the herniated stomach was reduced by nasogastric tube decompression, the patient experienced a recurrence of gastric hernia shortly thereafter. A laparoscopic operation was performed, and a new colostomy was constructed through an extraperitoneal route. The patient had no hernia recurrence during the 20 months of follow-up after the operation. Gastric internal hernia associated with colostomy can occur as a rare complication. Although reduction of the incarcerated stomach is possible by nasogastric tube decompression, surgical repair of the hernia may be the optimal management to prevent recurrence.
一名81岁女性因直肠癌接受了腹腔镜腹会阴联合切除术。通过腹腔途径建立了永久性结肠造口术。术后三个月,患者出现下腹痛和呕吐。计算机断层扫描显示胃通过提起的乙状结肠造口术的外侧间隙发生嵌顿。尽管通过鼻胃管减压使疝出的胃复位,但患者此后不久胃疝复发。进行了腹腔镜手术,并通过腹膜外途径构建了新的结肠造口术。术后20个月的随访期间,患者未出现疝复发。与结肠造口术相关的胃内疝是一种罕见的并发症。尽管通过鼻胃管减压可以使嵌顿的胃复位,但手术修复疝可能是预防复发的最佳治疗方法。