Krishnan R S, Kent R B
Department of Surgery, Carraway Methodist Medical Center, Birmingham, Alabama 35234, USA.
Surg Laparosc Endosc. 1998 Oct;8(5):388-9.
Intraoperative endoscopy has been accepted as a method of small bowel evaluation for occult gastrointestinal bleeding. Although methodology of the procedure has been evolving, reported complications have been few, consisting of prolonged ileus, adhesions, submucosal hemorrhage, and serosal injuries. This case report describes an enterovaginal fistula as a complication of intraoperative small bowel endoscopy performed during a total colectomy procedure in a patient with chronic gastrointestinal bleeding, possibly caused by ischemia resulting from pleating of small bowel over the endoscope. This complication may be prevented by use of longer commercially available enteroscopes or by use of an enterotomy to insert the endoscope.
术中内镜检查已被公认为是评估隐匿性胃肠道出血时小肠的一种方法。尽管该操作方法一直在不断发展，但报告的并发症却很少，包括肠梗阻延长、粘连、黏膜下出血和浆膜损伤。本病例报告描述了一名患有慢性胃肠道出血的患者在全结肠切除术中进行术中小肠内镜检查时发生肠阴道瘘这一并发症，可能是由于小肠在内镜上打褶导致缺血所致。使用更长的市售小肠镜或通过肠切开术插入内镜可预防此并发症。
