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病例报告:疝修补术后神经痛行皮神经射频消融术后肠穿孔

Case report: bowel perforation after cutaneous nerve radiofrequency ablation for postherniorrhaphy neuralgia.

作者信息

Neubauer Steven A, Capal Nicholas B, Reimer Sean C

机构信息

Department of General Surgery, Mercy Health St Elizabeth Youngstown Hospital, 1044 Belmont Ave, Youngstown, OH 44501, USA.

出版信息

J Surg Case Rep. 2022 Jul 7;2022(7):rjab592. doi: 10.1093/jscr/rjab592. eCollection 2022 Jul.

Abstract

Postoperative inguinal neuralgia is a known complication of open or laparoscopic herniorrhaphy, initially managed conservatively with analgesics. If symptoms do not resolve additional treatment modalities include nerve blocks, mesh explanation, neurectomy or radiofrequency ablation. Radiofrequency ablation is also used for ablation of hepatic tumors, and thermal injury to bowel is a known and well-documented complication with its use on the liver. There is no published literature or case reports describing thermal injury to bowel from radiofrequency ablation of ilioinguinal or iliohypogastric nerves. We present a case of a 44-year-old male with postoperative inguinal neuralgia following bilateral herniorrhaphies. He failed conservative management and underwent hot radiofrequency ablation of bilateral ilioinguinal and iliohypogastric nerves and presented with delayed small bowel perforation due to thermal injury.

摘要

术后腹股沟神经痛是开放或腹腔镜疝修补术已知的并发症,最初采用镇痛药进行保守治疗。如果症状未缓解,其他治疗方式包括神经阻滞、补片松解、神经切除术或射频消融。射频消融也用于肝肿瘤的消融,并且在肝脏使用时,肠道热损伤是一种已知且有充分文献记载的并发症。尚无已发表的文献或病例报告描述髂腹股沟或髂腹下神经射频消融导致的肠道热损伤。我们报告一例44岁男性,双侧疝修补术后出现腹股沟神经痛。他保守治疗失败,接受了双侧髂腹股沟和髂腹下神经的热射频消融,随后因热损伤出现延迟性小肠穿孔。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d78e/9262391/e91a2f2f223d/rjab592f1.jpg

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