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与术后吻合口部位梗阻相关的黏液嵌塞：1例罕见病例

Mucus Impaction Related to Postoperative Anastomosis Site Obstruction: A Rare Case.

作者信息

Yang Fu-Fei, Chan Ren-Hao

机构信息

Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TWN.

Division of Colorectal Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, TWN.

出版信息

Cureus. 2024 Apr 11;16(4):e58048. doi: 10.7759/cureus.58048. eCollection 2024 Apr.

DOI:10.7759/cureus.58048
PMID:38738003
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11088394/
Abstract

Anastomotic stricture has an incidence rate of 6-10% and typically manifests three to six months after colorectal surgery. Immediate postoperative stricture is exceedingly rare and underreported in the literature. The possible etiology includes poor circulation, leakage, local inflammation, or infection. We report a rare case of a patient with total obstruction by mucus on the anastomosis site on postoperation day two. We used a sigmoidoscope to remove mucus material, following which the patient recovered well.

摘要

吻合口狭窄的发生率为6% - 10%，通常在结直肠手术后三至六个月出现。术后即刻狭窄极为罕见，文献报道较少。可能的病因包括血运不佳、渗漏、局部炎症或感染。我们报告一例罕见病例，患者在术后第二天吻合口处被黏液完全阻塞。我们使用乙状结肠镜清除黏液物质，此后患者恢复良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d33/11088394/004b624b7d23/cureus-0016-00000058048-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d33/11088394/c0e145a4854b/cureus-0016-00000058048-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d33/11088394/7214ac3d0d4c/cureus-0016-00000058048-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d33/11088394/4413c83015cb/cureus-0016-00000058048-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d33/11088394/004b624b7d23/cureus-0016-00000058048-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d33/11088394/c0e145a4854b/cureus-0016-00000058048-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d33/11088394/7214ac3d0d4c/cureus-0016-00000058048-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d33/11088394/4413c83015cb/cureus-0016-00000058048-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d33/11088394/004b624b7d23/cureus-0016-00000058048-i04.jpg

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本文引用的文献

1
Colon mucus in colorectal neoplasia and beyond.结直肠肿瘤及其他病变中的结肠黏液
World J Gastroenterol. 2022 Aug 28;28(32):4475-4492. doi: 10.3748/wjg.v28.i32.4475.
2
Management of benign anastomotic strictures following rectal resection: a systematic review.直肠切除术后良性吻合口狭窄的处理：系统评价。
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Endoscopic diagnosis and treatment of complete anastomosis stenosis after colorectal resection without protective ileostomy: report of two cases and literature review.
内镜诊断和治疗无保护性回肠造口术的结直肠切除术后完全吻合口狭窄：两例报告及文献复习。
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Dis Colon Rectum. 2014 Oct;57(10):1195-201. doi: 10.1097/DCR.0000000000000207.
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Colorectal anastomotic stricture: is it associated with inadequate colonic mobilization?结直肠吻合口狭窄：是否与结肠游离不足有关？
Tech Coloproctol. 2013 Aug;17(4):371-5. doi: 10.1007/s10151-012-0929-z. Epub 2012 Nov 15.
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Risk factors for colorectal anastomotic stenoses and their impact on quality of life: what are the lessons to learn?结直肠吻合口狭窄的危险因素及其对生活质量的影响：有哪些经验教训值得吸取？
Colorectal Dis. 2012 Mar;14(3):e124-8. doi: 10.1111/j.1463-1318.2011.02819.x.
8
Colorectal anastomotic stenosis after elective laparoscopic sigmoidectomy for diverticular disease: a prospective evaluation of 68 patients.择期腹腔镜乙状结肠切除术治疗憩室病后结直肠吻合口狭窄：68例患者的前瞻性评估
Dis Colon Rectum. 2008 Sep;51(9):1345-9. doi: 10.1007/s10350-008-9319-z. Epub 2008 May 3.
9
Predictive factors of stenosis after stapled colorectal anastomosis: prospective analysis of 179 consecutive patients.吻合器结直肠吻合术后狭窄的预测因素：179例连续患者的前瞻性分析
World J Surg. 2004 Sep;28(9):921-5. doi: 10.1007/s00268-004-7375-7.