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中叶肺脓肿:腹腔镜胆囊切除术的迟发性并发症。

Middle Pulmonary Lobe Abscess: A Delayed Complication of Laparoscopic Cholecystectomy.

出版信息

Chirurgia (Bucur). 2022 Jun;117(3):357-361. doi: 10.21614/chirurgia.2414.

Abstract

Laparoscopic cholecystectomy has become a routine procedure in abdominal surgery, a "gold standard" in the treatment of gallstones. Iatrogenic perforation of the gallbladder during a cholecystectomy is a possible incident, with numerous complications due to unidentified intraperitoneal gallstones during surgery. Pulmonary complications of laparoscopic cholecystectomy are extremely rare. Case report: This report presents the case of a 62-year-old female with post cholecystectomy subphrenic abscess and trans-diaphragmatic fistula in the middle pulmonary lobe. In this case, the pulmonary symptoms dominated the clinical picture and the initial complementary explorations indicated a strictly pulmonary condition. The initial evolution of the patient was towards worsening, and the subsequent explorations established the real diagnosis. Conclusion: Gallbladder perforations with accidental loss of gallstones should be recognized immediately and managed. In the development of a pulmonary abscess, we can take into account an intra-peritoneal condition as well.

摘要

腹腔镜胆囊切除术已成为腹部外科的常规手术,是治疗胆结石的“金标准”。在胆囊切除术中,医源性胆囊穿孔是一种可能发生的情况,由于术中未能识别出腹腔内的胆结石,可能会导致多种并发症。腹腔镜胆囊切除术的肺部并发症极为罕见。病例报告:本报告介绍了一例 62 岁女性患者,在胆囊切除术后出现膈下脓肿和中肺叶横膈疝。在这种情况下,肺部症状主导了临床表现,最初的补充检查提示存在严格的肺部疾病。患者的初始病情恶化,随后的检查确定了真正的诊断。结论:应立即识别和处理意外丢失的胆囊结石引起的胆囊穿孔。在肺脓肿的发展过程中,我们也可以考虑腹腔内的情况。

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