Khalid Abdullahi, Umar Ahmed Mohammed, Abdulwahab-Ahmed Abdullah, Muhammad Abubakar Sadiq, Agwu Ngwobia Peter, Mungadi Ismaila A
Tetfund Centre of Excellence in Urology and Nephrology, Institute of Urology and Nephrology, Usmanu Danfodiyo University and Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.
J West Afr Coll Surg. 2021 Jan-Mar;11(1):33-37. doi: 10.4103/jwas.jwas_78_22. Epub 2022 Jun 22.
Herein is a case of a 51-year-old farmer who presented to our facility with initial leakage of urine but later urine mixed with faeces from the lower abdomen after two previous abdominal surgeries. He had an open transvesical prostatectomy due to benign prostate enlargement complicated by leakage of urine from lower abdominal wall scar. A repeat surgical intervention to correct the urine leakage was followed by recurrence of urine leakage and later by leakage of feculent urine from the lower anterior abdominal wall. At our facility, he had exploratory laparotomy with manual unknotting of ileal loops, fistula tracts excision, resection, and end-to-end ileoileal anastomosis. The bladder wall was repaired with suprapubic cystostomy. Although the finding of asymptomatic multiple small bowel knotting was incidental in the index case, its timely management averted a sitting timed bomb that may lead to a diagnostic dilemma with catastrophic consequences.
本文介绍了一例51岁农民的病例，该患者因先前两次腹部手术后最初出现尿液渗漏，后来下腹部出现尿液与粪便混合的情况。由于良性前列腺增生并发下腹壁瘢痕处尿液渗漏，他接受了开放性经膀胱前列腺切除术。在进行重复手术干预以纠正尿液渗漏后，尿液渗漏复发，随后前下腹壁出现粪性尿液渗漏。在我们的医疗机构，他接受了剖腹探查术，手动解开肠袢，切除瘘管，进行肠切除以及端端回肠吻合术。膀胱壁通过耻骨上膀胱造瘘术进行修复。尽管在该病例中发现无症状的多个小肠打结是偶然的，但对其及时处理避免了一个定时炸弹，否则可能导致诊断困境并产生灾难性后果。
