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减重手术再次手术后的多种复杂并发症(罕见并发症:脾动脉与胃残余之间的瘘管):一例报告

Multiple Complex Complications After Redo Bariatric Surgery (Infrequent Complication: Fistula Between the Splenic Artery and the Remnant of the Stomach): A Case Report.

作者信息

Abdolhosseini Mohammadreza, Haj Mohamad Ebrahim Ketabforoush Arsh, Parhizgar Parynaz, Tavallaei Mehdi

机构信息

Department of Surgery, Nikan Hospital, Tehran, Iran.

Student Research Committee, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran.

出版信息

Clin Med Insights Case Rep. 2022 Apr 19;15:11795476221088494. doi: 10.1177/11795476221088494. eCollection 2022.

Abstract

With the epidemic prevalence of obesity in today's society, bariatric surgery has become very popular in treating severe obesity. Although the complications of this surgery have decreased with the advancement of medicine and post-treatment care, there are still complications that can lead to death if neglected. In this case report, we present a 44-year-old patient who underwent redo bariatric surgery. She was discharged from the hospital in good general condition but returned a few days later with a major complaint of abdominal pain and sudden bleeding from the upper gastrointestinal tract. After performing CT and endoscopy and considering the results, the patient underwent laparotomy, which showed a fistula between the splenic artery and the remnant of the stomach. After surgery and after the recovery period, the patient was discharged from the hospital. In this case report, we describe for the first time an uncommon and unique complication following redo bariatric surgery. We suggest that a fistula between the splenic artery and the remnant of the stomach should be considered in patients with abdominal pain and upper gastrointestinal bleeding who underwent redo bariatric surgery.

摘要

在当今社会肥胖症流行的情况下,减肥手术在治疗重度肥胖方面变得非常普遍。尽管随着医学进步和术后护理,该手术的并发症有所减少,但仍存在一些并发症,若被忽视可能导致死亡。在本病例报告中,我们介绍了一位44岁接受再次减肥手术的患者。她出院时总体状况良好,但几天后因主要抱怨腹痛和上消化道突然出血而返回。在进行CT和内窥镜检查并考虑检查结果后,患者接受了剖腹手术,结果显示脾动脉与胃残余部分之间存在瘘管。手术后经过恢复期,患者出院。在本病例报告中,我们首次描述了再次减肥手术后一种罕见且独特的并发症。我们建议,对于接受再次减肥手术且出现腹痛和上消化道出血的患者,应考虑脾动脉与胃残余部分之间存在瘘管的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc9/9021477/9dd44943dde4/10.1177_11795476221088494-fig1.jpg

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