DiChiacchio Laura, O'Neill Natalie A, Kligman Mark, Bafford Andrea C
Department of Surgery, University of Maryland School of Medicine, Baltimore MD, USA.
J Surg Case Rep. 2020 Oct 24;2020(10):rjaa361. doi: 10.1093/jscr/rjaa361. eCollection 2020 Oct.
Surgical staplers are ubiquitous in gastrointestinal surgery, especially laparoscopy. Intraperitoneal staples are designed to be inert and are generally regarded as benign; however, complications from primarily malformed staples can rarely occur. Here, we present a case of early mechanical postoperative small bowel obstruction due to a surgical staple following laparoscopic total abdominal colectomy and end ileostomy creation performed for medically refractory ulcerative colitis. Management consisted of diagnostic laparoscopy and careful extraction of a malformed surgical staple tethering a loop of small bowel to the rectal stump. Eight similar cases following gastrointestinal surgery have been identified in the literature, all occurring in the first 2 weeks following laparoscopic appendectomy. To our knowledge, this is the first case described following laparoscopic total abdominal colectomy, with high-grade small bowel obstruction at the level of the rectal stump staple line.
外科吻合器在胃肠手术中无处不在，尤其是在腹腔镜手术中。腹腔内吻合钉被设计为惰性的，通常被认为是良性的；然而，主要由畸形吻合钉引起的并发症很少发生。在此，我们报告一例因手术吻合钉导致的术后早期机械性小肠梗阻病例，该患者因药物治疗无效的溃疡性结肠炎接受了腹腔镜全腹结肠切除术和末端回肠造口术。治疗方法包括诊断性腹腔镜检查以及小心取出将一段小肠系于直肠残端的畸形手术吻合钉。文献中已发现8例胃肠道手术后的类似病例，均发生在腹腔镜阑尾切除术后的前2周。据我们所知，这是首例腹腔镜全腹结肠切除术后发生的病例，直肠残端吻合钉线处出现高位小肠梗阻。
