肠膨出伴肠梗阻1例报告

María Cuaresma-González, Sonia De-Miguel-Manso, Paula Suárez-Mansilla, Marta Ibáñez-Nieto, Esther Ruiz Pérez, Álvaro Sanz Díaz-Heredero
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引用次数: 0

摘要

目的:探讨盆腔器官脱垂患者肠膨出伴肠缺血高危的诊断和治疗。方法:我们描述了一例81岁的高血压、肥胖、房颤抗凝和盆腔器官脱垂的临床病例。最初因手术风险高,给予保守治疗,但一段时间后患者因肠膨出和肠缺血风险来到急诊科。结果:将患者置于Trendelenburg体位并在会阴处敷冰后,脱垂减轻。随后,进行紧急手术干预,包括阴道全子宫切除术、前阴道破裂术、里奇氏手术和阴道缝合术。该干预既解决了患者的临床状况,又避免了小肠缺血。结论:晚期肠膨出伴肠梗阻的诊断是一种非常罕见但潜在严重的临床病例。由于阴道破裂、肠坏死和全身性感染的风险,立即识别和处理是非常重要的。
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Enterocele with Risk of Intestinal Incarceration: A Case Report
Purpose: To describe the diagnosis and management of enterocele with high risk of bowel ischemia in patients with pelvic organ prolapse. Methods: We describe the clinical case of an 81-year-old patient, hypertensive, obese, anticoagulated because of an atrial fibrillation and pelvic organ prolapse. Initially, conservative treatment was offered due to the high surgical risk, but sometime later the patient came to the emergency department with enterocele and risk of intestinal ischemia. Results: After placing the patient in the Trendelenburg position and applying ice to the perineum, the prolapse is reduced. Subsequently, urgent surgical intervention is performed with a total vaginal hysterectomy, anterior colporrhaphy, Ritcher's operation and colpoperineorrhaphy. This intervention solved the patient's clinical condition and also avoided the small bowel ischemia. Conclusion: The diagnosis of advanced enterocele with risk of intestinal obstruction is a very rare but potentially serious clinical case. The immediate recognition and management are very important because of the risk of vaginal rupture, intestinal necrosis, and also systemic infection.
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