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复杂性肠膨出:经阴道途径行肠切除术及时解决:病例报告

Complicated enterocele: timely resolution with bowel resection via a vaginal approach: case report.

作者信息

Abis Paola, Madeddu Clelia, Magro Malosso Giovanni, Sole Gabriele, Mereu Alessia, Locci Giorgia, Macciò Antonio

机构信息

Department of Obstetrics and Gynecology, ARNAS G. Brotzu, Cagliari, Italy.

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

出版信息

Front Surg. 2023 Jul 13;10:1228981. doi: 10.3389/fsurg.2023.1228981. eCollection 2023.

Abstract

BACKGROUND

Enterocele is an uncommon, serious condition that requires accurate and early diagnosis to prevent complications such as intestinal obstruction, incarceration, and strangulation, with consequent intestinal ischemia, necrosis, and evisceration. We report a rare case of a patient with a voluminous enterocele and initial signs of intestinal ischemia who underwent urgent vaginal surgery.

CASE DESCRIPTION

An 80-year-old woman presented with a voluminous mass protruding from the vagina, associated abdominopelvic pain, a 10-day history of bowel sub-occlusion, and numerous episodes of profuse vaginal bleeding. She was diagnosed with an enterocele with early signs of complications. Owing to her advanced clinical condition and comorbidities, we opted for an urgent vaginal procedure. Intestinal loops with initial signs of ischemia were resected via a transvaginal approach, leading to good clinical outcomes. She was discharged on postoperative day 5.

CONCLUSIONS

This rare case highlights a surgical emergency that was managed with transvaginal resection of the intestine. Early identification of the initial signs of complications allowed for this less invasive approach, resulting in reduced morbidity and length of hospital stay.

摘要

背景

肠膨出是一种罕见的严重病症,需要准确且早期诊断以预防诸如肠梗阻、嵌顿和绞窄等并发症,进而避免随之而来的肠缺血、坏死和肠管脱出。我们报告一例罕见病例,患者有巨大肠膨出且出现肠缺血的初始迹象,接受了紧急阴道手术。

病例描述

一名80岁女性,阴道突出巨大肿物,伴有腹盆腔疼痛、10天的肠道不全梗阻病史以及多次大量阴道出血。她被诊断为伴有早期并发症迹象的肠膨出。鉴于其晚期临床状况和合并症,我们选择了紧急阴道手术。经阴道途径切除有缺血初始迹象的肠袢,取得了良好的临床效果。她于术后第5天出院。

结论

这个罕见病例凸显了通过经阴道肠切除处理的外科急症。早期识别并发症的初始迹象使得能够采用这种侵入性较小的方法,从而降低了发病率并缩短了住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9094/10372482/eaccc089df10/fsurg-10-1228981-g001.jpg

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