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非创伤性自发性经阴道小肠脱出:一种罕见的外科急症。

Atraumatic Spontaneous Transvaginal Small Bowel Evisceration: A Rare Surgical Emergency.

作者信息

Fuentes Kevin J, Arechavala Lopez Sara Fernanda, Fuentes Irving, Leal Hidalgo Jorge, Martínez Zarate Juan Jacobo

机构信息

General Surgery, Médica Sur, Mexico City, MEX.

Medicine, Universidad Autónoma Metropolitana, Mexico City, MEX.

出版信息

Cureus. 2024 Mar 20;16(3):e56564. doi: 10.7759/cureus.56564. eCollection 2024 Mar.

Abstract

Abdominal pain ranks as the predominant cause for emergency department consultations. Although rare, transvaginal evisceration of the small intestine necessitates immediate surgical intervention due to its potential to induce intestinal ischemia and peritonitis. Key risk factors include postmenopausal status, a history of gynecologic surgery, and heightened abdominal pressure. Clinical presentation typically involves pain and protrusion of intestinal contents or even abdominal viscera. Diagnosis relies on thorough clinical assessment, and treatment strategies should be tailored to each patient. Here, we describe the case of a 65-year-old female patient with a non-traumatic evisceration of the ileum, who had undergone total abdominal hysterectomy following anterior colpocele a year ago, subsequently necessitating exploratory laparotomy and repair of the vaginal ampulla.

摘要

腹痛是急诊就诊的主要原因。虽然经阴道小肠脏器脱出很少见,但因其有导致肠缺血和腹膜炎的可能,所以需要立即进行手术干预。主要危险因素包括绝经后状态、妇科手术史和腹压升高。临床表现通常包括肠内容物甚至腹腔脏器的疼痛和突出。诊断依靠全面的临床评估,治疗策略应根据每个患者的情况量身定制。在此,我们描述一例65岁女性患者,其发生非创伤性回肠脏器脱出,一年前因前阴道壁膨出接受了全腹子宫切除术,随后需要进行剖腹探查和阴道穹窿修补术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b519/11029815/043ffed050e7/cureus-0016-00000056564-i01.jpg

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