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根治性胃切除术后上腹部切口下的异位骨化:两例报告

Heterotopic ossification beneath the upper abdominal incision after radical gastrectomy: Two case reports.

作者信息

Zhang Xiang, Xia Ping-Tian, Ma Yan-Chao, Dai Yong, Wang Yan-Lei

机构信息

Department of Colorectal Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.

Department of Radiology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.

出版信息

World J Clin Cases. 2022 Jun 16;10(17):5805-5809. doi: 10.12998/wjcc.v10.i17.5805.

Abstract

BACKGROUND

Heterotopic ossification (HO) is a rare clinical phenomenon that refers to bone formation in nonossifying tissues.

CASE SUMMARY

This report presents two cases of HO beneath the upper abdominal median incision after radical gastrectomy. The first patient had postoperative pain below the incision area. There were no signs of anastomotic leakage, and the wound healed. Computed tomography (CT) findings 2 wk postoperatively were negative for HO, but the 6-wk CT showed HO beneath the incision. The patient refused reoperation, and after conservative therapy, the pain was gradually relieved after 2 wk. In the second case, postoperative recovery was uneventful, and HO was only detected on routine follow-up CT after 4 mo. An anti-adhesion membrane was applied beneath the peritoneum in both patients. Our findings suggest that HO beneath the abdominal incision might form at approximately 1 mo postoperatively. It may cause intractable pain; however, reoperation is usually not required.

CONCLUSION

In our cases, we suspect that HO may be related to the use of foreign materials beneath the peritoneum, which needs to be further investigated.

摘要

背景

异位骨化(HO)是一种罕见的临床现象,指在非骨化组织中形成骨组织。

病例总结

本报告介绍了两例根治性胃切除术后上腹部正中切口下方发生HO的病例。首例患者切口区域下方出现术后疼痛。无吻合口漏迹象,伤口愈合。术后2周计算机断层扫描(CT)结果显示无HO,但6周时CT显示切口下方有HO。患者拒绝再次手术,经保守治疗后,2周后疼痛逐渐缓解。第二例患者术后恢复顺利,仅在4个月后的常规随访CT检查时发现HO。两例患者均在腹膜下应用了防粘连膜。我们的研究结果表明,腹部切口下方的HO可能在术后约1个月形成。它可能导致顽固性疼痛;然而,通常不需要再次手术。

结论

在我们的病例中,我们怀疑HO可能与腹膜下使用异物有关,这需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6ab/9258368/0564f06605d4/WJCC-10-5805-g001.jpg

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