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膈肌疝伴胃扭转及完全性胃出口梗阻

Diaphragmatic Hernia with Gastric Volvulus and Complete Gastric Outlet Obstruction.

作者信息

Al-Masari Hayder, Nofal Heba, Majdalawi Rawan, Ainawi Reham, Alwahedi Abdulwahid, Mahdi Tarek

机构信息

Bariatric Unit, General Surgery Department, Al-Qassimi Hospital, Sharjah, United Arab Emirates.

出版信息

J Minim Invasive Surg. 2020 Dec 15;23(4):197-200. doi: 10.7602/jmis.2020.23.4.197.

Abstract

A combination of Cytoreductive surgery (CRS) along with hyperthermic intraperitoneal chemotherapy (HIPEC) considers a crucial approach in treating designated patients with alimentary and gynecological malignancies with the involvement of the peritoneal cavity. The foremost frequent surgical complications are leakage, digestive perforations, fistulas, intestinal obstruction, abscess, and peripancreatitis. This report presents a case of a patient with a late acquired herniation of guts through the diaphragm after CRS and HIPEC that were already done 6 months back. A 26 -yearold male previously treated with CRS and HIPEC for testicular mesothelioma with peritoneal involvement, was admitted to our unit with the diagnosis of gastric outlet obstruction. His CT scan illustrated a left diaphragmatic hernia involving the stomach and splenocolic flexure. Each denudation of the diaphragmatic serosa throughout CRS which typically occurs during the surgical operation in a combination of the HIPEC heat can explain such complication. The herniation is extremely uncommonly diagnosed after CRS and HIPEC. Surgical techniques for hernia repair can be done by direct suturing of the defect or closure with artificial or biological tissue, each technique is a potential surgical technique for repair with reliable long-run results.

摘要

细胞减灭术(CRS)联合腹腔内热灌注化疗(HIPEC)被认为是治疗指定的伴有腹膜腔受累的消化道和妇科恶性肿瘤患者的关键方法。最常见的手术并发症是渗漏、消化穿孔、瘘管、肠梗阻、脓肿和胰周炎症。本报告介绍了一例患者,在6个月前已进行CRS和HIPEC后,晚期出现肠管经膈肌疝出。一名26岁男性此前因睾丸间皮瘤伴腹膜受累接受了CRS和HIPEC治疗,因胃出口梗阻诊断入院。他的CT扫描显示左膈肌疝,累及胃和脾结肠曲。在CRS期间膈肌浆膜的每次剥脱,通常发生在联合HIPEC加热的手术操作过程中,这可以解释这种并发症。CRS和HIPEC后极少诊断出疝出。疝修补的手术技术可通过直接缝合缺损或用人造或生物组织封闭,每种技术都是一种潜在的具有可靠长期效果的修补手术技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b9a/9012209/527ce38a85f4/JMIS-23-4-197-f1.jpg

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