Varlas Valentin Nicolae, Bălescu Irina, Varlas Roxana Georgiana, Adnan Al-Aloul, Filipescu Alexandru George, Bacalbașa Nicolae, Suciu Nicolae
Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 011132 Bucharest, Romania.
Department of Obstetrics and Gynaecology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
J Clin Med. 2025 Jan 5;14(1):262. doi: 10.3390/jcm14010262.
Despite its low incidence, complete postoperative abdominal evisceration represents a complication requiring an urgent solution. We aimed to present a rare case of an abdominal evisceration of the omentum and small-bowel loops after a total abdominal hysterectomy and review the literature regarding this condition's diagnosis and therapeutic management. On the sixth postoperative day for a uterine fibroid, a 68-year-old patient presented with an abdominal evisceration of the omentum and small bowel that occurred two hours before. An emergency laparotomy was performed to correct the evisceration and restore the integrity of the abdominal wall structure. The literature review was carried out in the PubMed, Embase, and Web of Science databases using the terms "abdominal wall dehiscence", "abdominal evisceration", "open abdomen", "burst abdomen", "abdominal fascial dehiscence", "abdominal dehiscence post-hysterectomy", and "hysterectomy complications" by identifying all-time articles published in English. Seven studies were included in this electronic search. The early diagnosis of abdominal evisceration, the identification of risk factors and comorbidities, followed by the choice of surgical technique, and postoperative follow-up were parts of the standard algorithm for managing this life-threatening case. Abdominal evisceration, as a surgical emergency, requires the diagnosis and treatment of this complication alongside the identification of the risk factors that can lead to its occurrence, as well as careful postoperative monitoring adapted to each case.
尽管术后全腹脏器脱出的发生率较低,但它是一种需要紧急解决的并发症。我们旨在呈现一例全腹子宫切除术后大网膜和小肠袢脏器脱出的罕见病例,并回顾有关该病症诊断和治疗管理的文献。在子宫肌瘤术后第六天,一名68岁患者出现了两小时前发生的大网膜和小肠脏器脱出。进行了急诊剖腹手术以纠正脏器脱出并恢复腹壁结构的完整性。使用“腹壁裂开”、“腹部脏器脱出”、“开放性腹部”、“腹部爆裂”、“腹部筋膜裂开”、“子宫切除术后腹部裂开”和“子宫切除术后并发症”等术语,在PubMed、Embase和Web of Science数据库中进行文献检索,以识别所有用英文发表的文章。本次电子检索纳入了七项研究。腹部脏器脱出的早期诊断、危险因素和合并症的识别、手术技术的选择以及术后随访是处理这一危及生命病例的标准算法的组成部分。作为一种外科急症,腹部脏器脱出需要对该并发症进行诊断和治疗,同时识别可能导致其发生的危险因素,并针对每个病例进行仔细的术后监测。