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Roux-en-y肠造口狭窄扩张后脾损伤行脾切除术:一种意外的并发症。

Splenectomy post-splenic injury following dilatation of Roux-en-y enterostomy stomal stricture: an unexpected complication.

作者信息

Bennet Simon, Spiro Calista, Burlak Kateryna, Lim Hou Kiat

机构信息

Surgery, Austin Health, Heidelberg, Victoria, Australia

Upper Gastrointestinal Surgery, Austin and Repatriation Medical Centre, Heidelberg, Victoria, Australia.

出版信息

BMJ Case Rep. 2021 Mar 25;14(3):e239882. doi: 10.1136/bcr-2020-239882.

Abstract

A 53-year-old woman presented in the early hours of the morning with generalised abdominal pain and features of hypovolaemic shock, following a dilatation of an enterostomy stricture 12 hours prior. Dilatation of this stricture was indicated by ongoing dysphagia, which had been successfully dilated twice before without incident. Standard resuscitative measures and confirmation of the endoscopically-caused splenic injury by CT scan were followed promptly by a splenectomy to control ongoing blood loss. The strictured enterostomy was revised to mitigate further need for endoscopic dilatation. The patient recovered well and was discharged shortly after on a soft diet.

摘要

一名53岁女性在凌晨时分出现全腹疼痛及低血容量性休克症状,12小时前因肠造口狭窄扩张术后出现上述情况。此次狭窄扩张是因持续吞咽困难所致,该患者此前已成功进行过两次扩张,均未发生意外。在采取标准复苏措施并通过CT扫描确认内镜导致的脾损伤后,立即进行了脾切除术以控制持续出血。对狭窄的肠造口进行了修复,以减少进一步内镜扩张的需求。患者恢复良好,不久后出院,饮食改为软食。

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