General Surgery, The Dudley Group NHS Foundation Trust, Dudley, UK.
Radiology, The Dudley Group NHS Foundation Trust, Dudley, UK.
BMJ Case Rep. 2021 Apr 16;14(4):e238720. doi: 10.1136/bcr-2020-238720.
Colocutaneous fistula is a rare entity in colorectal disease. We present a case of colocutaneous fistula in a patient whose postoperative course following a laparoscopic anterior resection for sigmoid cancer was complicated by colitis. During the follow-up period, it was found that his bowel contents were preferentially discharging through this fistula which had taken up the role of an 'autocolostomy'. Given the physiological impact of an additional surgical procedure, a definitive repair of the fistula was deferred and instead the patient was taught to manage it in keeping with general principles of stoma care. Over the subsequent follow-up period, he has now developed a large parastomal hernia and is being considered for definitive repair.
肠皮瘘在结直肠疾病中较为罕见。我们报告了 1 例乙状结肠癌腹腔镜前切除术患者术后并发结肠炎,导致肠皮瘘。在随访期间,发现他的肠内容物优先通过该瘘口排出,瘘口已起到“自体肠造口”的作用。鉴于再次手术会对患者生理造成影响,我们暂未对瘘口进行确定性修复,而是根据造口护理的一般原则指导患者对瘘口进行管理。在随后的随访期间,患者出现了较大的造口旁疝,目前正在考虑进行确定性修复。