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腹腔镜胆囊切除术后发生肠系膜缺血的罕见病例。

A rare case of mesentric ischaemia post laparoscopic cholecystectomy.

作者信息

Prakash Ved, Faraz Mirza, Sharma Abhishek, Agrawal Anirudh

机构信息

Asian Institute of Medical Sciences, Faridabad, Haryana 121001, India.

Department of General Surgery, Asian Institute of Medical Sciences, Faridabad, Haryana 121001, India.

出版信息

J Surg Case Rep. 2025 Feb 28;2025(2):rjaf090. doi: 10.1093/jscr/rjaf090. eCollection 2025 Feb.

Abstract

Laparoscopic cholecystectomy (LC) has become the standard treatment for gallstones. Current experience indicates that in more than 95% of cases, the procedure is safe and can be performed without complications with mortality rate of 0.2%. Death following this surgery is devastating to people all around the world as it is the safest and most common surgery done world-wide. Intestinal ischaemia is a rarely reported complication following LC. We describe a case of massive small intestinal necrosis 2 days following this procedure. After excluding all the known causes, we determined the cause to be splanchnic hypoperfusion, likely due to the physiologic changes induced by the pneumoperitoneum and elevated intra-abdominal pressure, necessary to conduct the surgery, among all the cases reported of mesenteric ischaemia have comorbidities and, in our case, the patient is having no comorbidities.

摘要

腹腔镜胆囊切除术(LC)已成为胆结石的标准治疗方法。目前的经验表明,在超过95%的病例中,该手术是安全的,可在无并发症的情况下进行,死亡率为0.2%。由于这是全球范围内最安全、最常见的手术,术后死亡对世界各地的人们来说都是毁灭性的。肠缺血是LC术后一种很少被报道的并发症。我们描述了1例该手术后2天出现大面积小肠坏死的病例。在排除所有已知病因后,我们确定病因是内脏灌注不足,这可能是由于气腹和手术所需的腹腔内压力升高引起的生理变化所致。在所有报道的肠系膜缺血病例中患者均有合并症,而我们的病例中患者没有合并症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74eb/11879133/34b5b418e746/rjaf090f1.jpg

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