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因严重渗漏继发腹腔脓肿时脓肿腔与肠道的同步引流:一例报告

Simultaneous Drainage of the Abscess Cavity and Intestinal Tract for an Intra-abdominal Abscess Secondary to Major Leakage: A Case Report.

作者信息

Ueno Yutaka, Kariya Shuji, Nakatani Miyuki, Ono Yasuyuki, Maruyama Takuji, Komemushi Atsushi, Tanigawa Noboru

机构信息

Department of Radiology, Kansai Medical University, Japan.

出版信息

Interv Radiol (Higashimatsuyama). 2020 Jan 17;5(1):10-13. doi: 10.22575/interventionalradiology.2019-0001. eCollection 2020 Feb 28.

Abstract

This case report describes a 72-year-old man who developed an intra-abdominal abscess and major postoperative anastomotic leakage. He reported a history of pancreaticoduodenectomy, partial hepatectomy, and segmental colectomy for hepatic and colonic invasion of extrahepatic cholangiocarcinoma. Three catheters, (one in the transverse colon and two in the abscess cavity) were placed simultaneously through the drainage tract formed by the intraoperatively placed Pleats drain. The intra-abdominal abscess resolved following this intervention and has not recurred since. Postoperative drainage and starvation were continued for 52 and 84 days, respectively. This case report describes a novel technique of catheter insertion from the abscess cavity into the intestine through the site of rupture to reduce intestinal pressure and partially block the enteric fistula.

摘要

本病例报告描述了一名72岁男性,他发生了腹腔内脓肿和术后严重吻合口漏。他有因肝外胆管癌侵犯肝脏和结肠而接受胰十二指肠切除术、部分肝切除术和节段性结肠切除术的病史。通过术中放置的褶式引流管形成的引流通道,同时放置了三根导管(一根在横结肠,两根在脓肿腔内)。经过此干预后,腹腔内脓肿消退,此后未再复发。术后分别持续引流和禁食52天和84天。本病例报告描述了一种通过破裂部位从脓肿腔插入肠道的导管插入新技术,以降低肠内压力并部分封闭肠瘘。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d875/9550393/521bedb5ea23/2432-0935-5-1-0010-g001.jpg

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