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氩离子凝固术与内镜下止血夹在术后胃肠瘘治疗中的应用

Use of Argon Plasma Coagulation and Endoscopic Hemoclips for Postsurgical Gastrointestinal Fistula.

作者信息

Sohail Abdullah, Khan Ahmad, Shah Hamza, Rezko Ragheb

机构信息

West Virginia University Charleston Division, Charleston, West Virginia, USA.

Charleston Area Medical Center, Charleston, West Virginia, USA.

出版信息

Case Rep Gastrointest Med. 2020 Nov 11;2020:8835437. doi: 10.1155/2020/8835437. eCollection 2020.

Abstract

A 72-year-old male was diagnosed with a duodenal mass and underwent extensive surgical resection. The patient's post-op course was complicated by an anastomotic leak that was first treated conservatively; however, his condition continued to deteriorate. An upper endoscopy was performed, which showed misplacement of drain forming a fistulous track through the lumen of the bowel. We removed the drain and used argon plasma coagulation to de-epithelize the lumen and closed the fistula with hemostasis clips. The patient's clinical status improved significantly. Our case emphasizes the success of endoscopic techniques as an alternative option in the management of postsurgical anastomotic leaks and fistulas in the right clinical setting and patient population.

摘要

一名72岁男性被诊断为十二指肠肿物并接受了广泛的手术切除。患者术后病程因吻合口漏而复杂化,最初采取保守治疗;然而,他的病情持续恶化。进行了上消化道内镜检查,结果显示引流管位置不当,形成了一条穿过肠腔的瘘管。我们取出了引流管,使用氩等离子体凝固术使肠腔去上皮化,并用止血夹封闭了瘘管。患者的临床状况显著改善。我们的病例强调了在合适的临床环境和患者群体中,内镜技术作为手术吻合口漏和瘘管管理的替代选择的成功性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5015/7673945/c077e6b62bca/CRIGM2020-8835437.001.jpg

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