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术中吲哚菁绿荧光引导切除治疗创伤后缺血性回肠狭窄

Management of post-traumatic ischaemic ileal stricture using intraoperative indocyanine green fluorescence-guided resection.

机构信息

Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India

Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.

出版信息

BMJ Case Rep. 2021 Aug 17;14(8):e242497. doi: 10.1136/bcr-2021-242497.

Abstract

Blunt abdominal trauma can affect mesenteric circulation which may lead to bowel strictures. Indocyanine green (ICG) angiography can be used to assess mesenteric blood flow and bowel perfusion as a guide to resect length intraoperatively. But this concept has not been applied to ischaemic bowel strictures. We present a case of ischaemic ileal stricture induced by blunt abdominal trauma which was managed by resection and anastomosis. Intraoperative near-infrared (NIR) ICG angiography was used as a guide to resect the bowel length. This case emphasises that ischaemic bowel strictures should be suspected in patients presenting with intestinal obstruction following trauma. Resection and anastomosis of the affected segment remains the primary treatment modality with excellent outcomes. NIR ICG angiography is a real-time objective and useful resource for assessing bowel perfusion and could be used to determine the length of the segment to be resected in patients with ischaemic bowel stricture.

摘要

钝性腹部创伤可影响肠系膜循环,导致肠狭窄。吲哚菁绿(ICG)血管造影可用于评估肠系膜血流和肠灌注,以指导术中切除长度。但这一概念尚未应用于缺血性肠狭窄。我们报告了一例钝性腹部创伤引起的缺血性回肠狭窄,采用切除和吻合术进行治疗。术中近红外(NIR)ICG 血管造影用于指导切除肠段的长度。本病例强调,创伤后出现肠梗阻的患者应怀疑存在缺血性肠狭窄。受累肠段的切除和吻合仍然是主要的治疗方式,且效果极佳。近红外 ICG 血管造影是评估肠灌注的实时客观且有用的资源,可用于确定缺血性肠狭窄患者需要切除的肠段长度。

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