根治性胃切除术后小吻合口瘘的检查结果差异及后续治疗：一例报告

Differences in examination results of small anastomotic fistula after radical gastrectomy with afterward treatments: A case report.

作者信息

Lu Chen-Yang, Liu Ya-Li, Liu Kui-Jie, Xu Shu, Yao Hong-Liang, Li Lun, Guo Zhu-Shu

机构信息

Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital of Central South University, Central South University, Changsha 410011, Hunan Province, China.

Department of General Surgery, The Second Xiangya Hospital of Central South University, Central South University, Changsha 410011, Hunan Province, China.

出版信息

World J Clin Cases. 2022 Jul 26;10(21):7609-7616. doi: 10.12998/wjcc.v10.i21.7609.

DOI:10.12998/wjcc.v10.i21.7609

PMID:36157983

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9353917/

Abstract

BACKGROUND

Gastrografin swallow, methylthioninium chloride test, and computed tomography (CT) are the main methods for postoperative anastomotic fistula detection. Correct selection and application of examinations and therapies are significant for the early diagnosis and treatment of small anastomotic fistulas after radical gastrectomy, which are conducive to postoperative recovery.

CASE SUMMARY

A 44-year-old woman underwent radical total gastrectomy for laparoscopic gastric cancer. The patient developed a fever after surgery. The methylthioninium chloride test and early CT suggested no anastomotic fistula, but gastrografin swallow and late CT showed the opposite result. The fistula was successfully closed using an endoscopic clip. The methylthioninium chloride test, gastrografin, and CT performed on different postoperative dates for small esophagojejunostomy fistulas are different. The size of the anastomotic fistula is an important factor for the success of endoscopic treatment.

CONCLUSION

The advantages and limitations of the diagnosis of different examinations of small esophagojejunostomy fistulas are noteworthy. The size of the leakage of the anastomosis is an important basis for selecting the repair method.

摘要