Löfgren Niklas, Gkekas Ioannis
ST-läkare, Kirurgcentrum, Norrlands universitetssjukhus, Umeå.
specialistläkare, Kirurgcentrum, Norrlands universitetssjukhus, Umeå.
Lakartidningen. 2021 Apr 12;118:20195.
Mechanical intestinal obstruction is an important diagnosis and a common cause of acute abdominal pain. Adhesions and scar tissue in the abdomen after previ-ous surgery is a frequent source. Small bowel obstruction caused by adhesions can be treated conservatively, but surgery may be needed. Laparotomy is usually the approach for adhesiolysis, but laparoscopy is an option. This case rapport describes a man in his 50s being admitted with severe abdominal pain and vomiting. Further investigation showed a small bowel obstruction caused by adhesions. After two days expectation, surgery be-came necessary. During laparoscopy, the surgeon's finger was introduced intraabdominally and used to release the adhesion. We here present a possible approach to a situation encountered during laparoscopic adhesiolysis and encourage creativity and laparoscopy in selected patients with mechanical small bowel obstruction.
机械性肠梗阻是一种重要的诊断,也是急性腹痛的常见原因。既往手术之后腹部的粘连和瘢痕组织是常见病因。粘连引起的小肠梗阻可保守治疗,但可能需要手术。剖腹手术通常是粘连松解的方法,但腹腔镜检查也是一种选择。本病例报告描述了一名50多岁的男性因严重腹痛和呕吐入院。进一步检查显示为粘连引起的小肠梗阻。经过两天的观察,手术成为必要。在腹腔镜检查期间,外科医生将手指伸入腹腔并用于松解粘连。我们在此介绍一种在腹腔镜粘连松解过程中遇到的情况的可能处理方法,并鼓励在选定的机械性小肠梗阻患者中发挥创造力并采用腹腔镜检查。