Okamoto Nobuyuki, Tazaki Tatsuya, Shintakuya Ryuta, Hirano Toshinori, Sasaki Masaru, Takahashi Shinya, Nakamitsu Astushi
Department of Surgery, JA Hiroshima General Hospital, Hiroshima, Japan.
Department of Surgery, JA Hiroshima General Hospital, Hiroshima, Japan.
Int J Surg Case Rep. 2020;73:196-198. doi: 10.1016/j.ijscr.2020.07.033. Epub 2020 Jul 16.
Fibrodysplasia ossificans progressiva (FOP) is a disorder causing progressive heterotopic ossification of muscles, tendons, and ligaments. Invasive procedures such as surgery should be avoided, because physical stimulation causes heterotopic ossification.
A 40-year-old Japanese man with FOP was transported to our hospital with sudden abdominal pain. Emergency surgery was performed because a computed tomography scan showed the presence of intraabdominal free air. We diagnosed peritonitis due to perforation of Meckel's diverticulum and performed a small intestinal resection. The day after surgery, airway obstruction was recognized, and tracheostomy was required. Six months after surgery, a strangulated small bowel obstruction developed, and a second laparotomy was performed. As the patient continued to have difficulty swallowing, we constructed a gastrostomy at the time of the second surgery. He was discharged with no complications.
Ossification of the abdominal incision wound due to surgical invasion was suspected, but it did not occur in the short term.
Two laparotomies could be performed safely in a patient with FOP.
进行性骨化性纤维发育不良（FOP）是一种导致肌肉、肌腱和韧带进行性异位骨化的疾病。应避免手术等侵入性操作，因为物理刺激会导致异位骨化。
一名40岁患有FOP的日本男性因突发腹痛被送往我院。计算机断层扫描显示腹腔内有游离气体，遂进行了急诊手术。我们诊断为梅克尔憩室穿孔导致的腹膜炎，并进行了小肠切除术。术后第二天，出现气道阻塞，需要进行气管切开术。术后六个月，发生绞窄性小肠梗阻，进行了第二次剖腹手术。由于患者持续存在吞咽困难，我们在第二次手术时进行了胃造口术。患者出院时无并发症。
怀疑手术侵袭导致腹部切口伤口骨化，但短期内未发生。
FOP患者可以安全地进行两次剖腹手术。
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