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腹壁成形术后的彼得森疝:是一个诱发因素还是一种巧合?

Petersen Hernia After Abdominoplasty: A Provocative Factor or a Coincidence?

作者信息

Caixeiro Leonor, Varanda João, Morais João, Ferreira António, Rios Leonor

机构信息

Plastic and Reconstructive Surgery, Centro Hospitalar V.N.Gaia/Espinho, Vila Nova de Gaia, PRT.

General Surgery, Centro Hospitalar V.N.Gaia/Espinho, Vila Nova de Gaia, PRT.

出版信息

Cureus. 2023 Sep 11;15(9):e45014. doi: 10.7759/cureus.45014. eCollection 2023 Sep.

Abstract

Abdominal contouring procedures are frequently performed following massive weight loss after a Roux-en-Y gastric bypass. This last procedure can be associated with late complications like the development of internal hernias (e.g., Petersen hernia). The purpose of this article is to present a case of Petersen hernia after complete abdominoplasty. A 42-year-old female presented to the emergency department with acute abdominal pain three days after undergoing a complete abdominoplasty following massive weight loss post laparoscopic gastric bypass (Roux-en-Y). The patient was diagnosed with a mechanical small bowel obstruction, likely due to an internal hernia (Petersen hernia) and underwent surgical correction. Gastric bypass surgery may be associated with small bowel obstruction from internal herniation. A sudden rise in abdominal pressure, as occurs with abdominoplasty with rectus plication and subsequent use of compression garments, may result in strangulation and intestinal ischemia. A high degree of suspicion of intra-abdominal complications after abdominoplasty is essential, particularly in the setting of post-bariatric surgery.

摘要

腹部塑形手术常在Roux-en-Y胃旁路术后大量减重后频繁进行。最后这个手术可能会伴有一些晚期并发症,比如内疝(如彼得森疝)的形成。本文的目的是呈现一例全腹壁成形术后发生彼得森疝的病例。一名42岁女性在腹腔镜胃旁路术(Roux-en-Y)后大量减重并接受全腹壁成形术后三天,因急性腹痛被送往急诊科。患者被诊断为机械性小肠梗阻,可能是由于内疝(彼得森疝),并接受了手术矫正。胃旁路手术可能与内疝导致的小肠梗阻有关。腹部压力突然升高,如在腹直肌折叠的腹壁成形术及随后使用紧身衣时发生的情况,可能会导致绞窄和肠缺血。对腹壁成形术后腹腔内并发症保持高度怀疑至关重要,尤其是在减肥手术后的情况下。

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