结核性腹膜炎致右髂总动脉-肠瘘1例报告

Right common iliac arterio-intestinal fistula caused by tubercular peritonitis: report of a case.

作者信息

Iwamoto I, Takechi Y, Tomoe H, Shimayama T, Edagawa M, Karashima S, Koga Y

机构信息

Department of Surgery, Miyazaki Shigun Ishikai Hospital, Japan.

出版信息

Surg Today. 1993;23(1):78-80. doi: 10.1007/BF00309005.

DOI:10.1007/BF00309005

PMID:8461610

Abstract

A 59-year-old female was admitted with massive hematemesis and melena. A hematological examination revealed that the red blood cell count was 1.31 x 10(6)/mm3, Hb 3.4 g/dl, and Hct 12%. No source of bleeding was found by an emergency endoscopic examination of the esophagus, stomach and duodenum, or by superior mesenteric angiography. At laparotomy a right common iliac arterio-intestinal fistula was found. The microscopic examination of this part of the ileum, including the fistula, revealed the presence of tubercular peritonitis. An extra-anatomic bypass graft using a prosthetic graft was performed between the left and right femoral arteries because reconstruction of the right common iliac artery was impossible.

摘要

一名59岁女性因大量呕血和黑便入院。血液学检查显示红细胞计数为1.31×10(6)/mm3，血红蛋白3.4 g/dl，血细胞比容12%。通过对食管、胃和十二指肠进行急诊内镜检查以及肠系膜上动脉造影，均未发现出血源。剖腹手术时发现右髂总动脉-肠瘘。对包括瘘管在内的回肠这一部分进行显微镜检查，发现存在结核性腹膜炎。由于无法重建右髂总动脉，遂在左、右股动脉之间使用人工血管进行解剖外旁路移植术。