腹膜透析导管置入过程中发生空肠穿孔：一例报告。
Jejunal perforation during peritoneal dialysis catheter placement: A case report.
作者信息
Raksasuk Sukit, Taweerautchana Woraboot, Srithongkul Thatsaphan
机构信息
Division of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
出版信息
Ann Med Surg (Lond). 2020 Jul 18;57:66-69. doi: 10.1016/j.amsu.2020.07.012. eCollection 2020 Sep.
INTRODUCTION
Bowel perforation is a rare but serious complication after peritoneal dialysis (PD) catheter insertion, which significantly increases mortality. Currently, there is no recommendation for preferring catheter insertion technique, since neither open surgical or percutaneous technique demonstrate superior outcome.
PRESENTATION OF CASE
This is a 78-year-old man who developed jejunal perforation during PD catheter placement, presenting with initial clear and satisfying PD fluid drainage. Bowel perforation was recognized after long dwell of PD fluid returned in yellowish color. Operative finding revealed a through and through jejunal wall perforation.
CONCLUSION
Satisfying dialysate flow and tip catheter location could not exclude accidental bowel perforation after PD catheter placement. Carefully patient monitoring is crucial in detecting postoperative complication.
引言
肠穿孔是腹膜透析（PD）导管插入术后一种罕见但严重的并发症，会显著增加死亡率。目前，对于首选的导管插入技术尚无推荐意见，因为开放手术技术和经皮技术均未显示出更好的效果。
病例介绍
这是一名78岁男性，在PD导管置入过程中发生空肠穿孔，最初腹膜透析液引流清晰且令人满意。在腹膜透析液长时间留置后返回呈黄色时才发现肠穿孔。手术发现为贯穿空肠壁的穿孔。
结论
腹膜透析液引流满意且导管尖端位置合适并不能排除PD导管置入术后意外肠穿孔的发生。仔细监测患者对于发现术后并发症至关重要。
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