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一例采用管腔贴壁金属支架经内镜坏死组织切除术成功治疗的盆腔壁内坏死病例。

A case of walled-off necrosis extending into the pelvic cavity successfully treated by endoscopic necrosectomy using a lumen-apposing metal stent.

作者信息

Morita Makoto, Yokota Tomoyuki, Yano Ryo, Amano Michiko, Ochi Hironori, Azemoto Nobuaki, Mashiba Toshie, Joko Kouji

机构信息

Center for Liver-Biliary-Pancreatic Diseases Matsuyama Red Cross Hospital Ehime Japan.

出版信息

DEN Open. 2022 Apr 23;2(1):e120. doi: 10.1002/deo2.120. eCollection 2022 Apr.

DOI:10.1002/deo2.120
PMID:35873503
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9302297/
Abstract

A 31-year-old man developed massive walled-off necrosis extending into the pelvic cavity following severe acute alcoholic pancreatitis. Endoscopic ultrasound-guided fistula drainage was performed using a lumen-apposing metal stent, but this was insufficiently effective, and endoscopic necrosectomy was also performed, after which the patient improved. Percutaneous drainage and surgery are other options for the treatment of walled-off necrosis extending into the pelvic cavity, but a valuable case in which the patient improved with endoscopic treatment alone is presented.

摘要

一名31岁男性在严重急性酒精性胰腺炎后出现大量包裹性坏死并蔓延至盆腔。采用管腔贴附金属支架进行内镜超声引导下瘘管引流，但效果不佳，随后还进行了内镜坏死组织切除术，患者病情好转。经皮引流和手术是治疗蔓延至盆腔的包裹性坏死的其他选择，但本文介绍了一例仅通过内镜治疗即获改善的宝贵病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f089/9302297/4d3008eec133/DEO2-2-e120-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f089/9302297/029bcb409b86/DEO2-2-e120-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f089/9302297/ce0eb664a965/DEO2-2-e120-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f089/9302297/a50825edb021/DEO2-2-e120-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f089/9302297/4d3008eec133/DEO2-2-e120-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f089/9302297/029bcb409b86/DEO2-2-e120-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f089/9302297/ce0eb664a965/DEO2-2-e120-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f089/9302297/a50825edb021/DEO2-2-e120-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f089/9302297/4d3008eec133/DEO2-2-e120-g004.jpg

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本文引用的文献

1
[EUS-guided therapy using a lumen-apposing metal stent].[使用管腔贴附金属支架的超声内镜引导下治疗]
Nihon Shokakibyo Gakkai Zasshi. 2018;115(12):1046-1056. doi: 10.11405/nisshoshi.115.1046.
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Cumulative risks of stent migration and gastrointestinal bleeding in patients with lumen-apposing metal stents.腔内贴壁金属支架患者支架移位和胃肠道出血的累积风险。
Endoscopy. 2018 Apr;50(4):386-395. doi: 10.1055/a-0581-9040. Epub 2018 Mar 7.
3
Interventions for walled off necrosis using an algorithm based endoscopic step-up approach: Outcomes in a large cohort of patients.
基于算法的内镜逐步升级方法治疗包裹性坏死的干预措施：在一大群患者中的结果。
Pancreatology. 2017 Sep-Oct;17(5):663-668. doi: 10.1016/j.pan.2017.07.195. Epub 2017 Jul 31.
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Factors determining recurrence of fluid collections following migration of intended long term transmural stents in patients with walled off pancreatic necrosis and disconnected pancreatic duct syndrome.影响带膜长期穿壁支架迁移后胰周积液复发的因素：包裹性胰腺坏死和胰腺导管分离综合征患者
Endosc Ultrasound. 2015 Jul-Sep;4(3):208-12. doi: 10.4103/2303-9027.162999.
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Endoscopic ultrasound-guided placement of plastic vs. biflanged metal stents for therapy of walled-off necrosis: a retrospective single-center series.内镜超声引导下置入塑料支架与双凸缘金属支架治疗包裹性坏死：一项回顾性单中心研究系列
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