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经皮液体引流后十二指肠穿孔,一种罕见情况:病例报告

Duodenal perforation after percutaneous fluid drainage, a rare event: a case report.

作者信息

Moyón Miguel A, Molina Gabriel A, Crisanto Braulio Aaron, Moyón F Xavier, Cárdenas Andrés, Buenaño Ricardo A, Gallegos Santiago E, Espinoza Sindy Mishel

机构信息

Chief of Department of General Surgery, Hospital San Francisco de Quito-IESS, Quito, Ecuador.

Department of General Surgery, Hospital IESS Quito Sur, Quito, Ecuador.

出版信息

J Surg Case Rep. 2020 Jul 2;2020(6):rjaa206. doi: 10.1093/jscr/rjaa206. eCollection 2020 Jun.

Abstract

Duodenal perforations can be caused by surgical instruments during operations. These injuries can go initially unnoticed and lead to problematic complications. While uncommon, bowel perforation after percutaneous fluid drainage can severely impact the patient's outcome. These can occur from equipment used for image-guided percutaneous drainage, a technique that has changed the way surgeons handle postoperative fluid collections and has become daily practice. Prompt recognition and timely treatment of these types of complications can minimize the consequences of this dreaded scenario. We present the case of a 29-year-old male, for whom an intra-abdominal collection was detected after laparoscopic cholecystectomy. CT-guided percutaneous drainage was performed, during which the catheter inadvertently punctured the duodenum. Surgical consultation was required and, since the patient remained asymptomatic, conservative management of the duodenal perforation was accomplished without complications. On follow-ups, the patient is doing well.

摘要

十二指肠穿孔可在手术过程中由手术器械引起。这些损伤起初可能未被察觉,并导致出现问题的并发症。虽然不常见,但经皮液体引流后肠穿孔会严重影响患者的预后。这些穿孔可能源于用于影像引导下经皮引流的设备,这种技术改变了外科医生处理术后液体聚集的方式,并且已成为日常操作。对这类并发症的迅速识别和及时治疗可将这种可怕情况的后果降至最低。我们报告一例29岁男性患者的病例,该患者在腹腔镜胆囊切除术后被检测出腹腔内有积液。进行了CT引导下经皮引流,在此过程中导管意外穿刺了十二指肠。需要外科会诊,由于患者仍无症状,对十二指肠穿孔进行了保守治疗,未出现并发症。在随访中,患者情况良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae81/7332287/1a31fa317ec0/rjaa206f1.jpg

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