- 期刊
Laparoscopic Treatment of Bezoar-induced Small Bowel Obstruction: Report of a Case
以腹腔鏡治療小腸糞石阻塞：病例報告
摘要
傳統上小腸糞石阻塞都是以開腹方式處理，或是以手捏碎，或是在糞石太大太硬時，從小腸表面開洞取出。近年來腹腔鏡手術已逐步使用在某些合適的小腸阻塞病患，進行診斷及治療。本文報告我們一例無腹部手術過往史的77歲男性，因小腸阻塞接受診斷性腹腔鏡手術，術中發現在遠端迴腸有一糞石造成小腸阻塞，經抓取鉗捏碎糞石後，推入盲腸解決病患腸阻塞。文獻回顧顯示腹腔鏡手術不僅可以用在小腸糞石阻塞的病患的診斷，在適當的病患，腹腔鏡手術或腹腔鏡輔助手術也可以安全有效地使用在小腸糞石阻塞的病患的治療。
關鍵字
無資料並列摘要
Treatment of bezoar-induced intestinal obstruction is usually performed by an open approach, with either digital fragmentation or removal of the bezoar via enterotomy. Laparoscopy is gaining increased acceptance for diagnosis and treatment of selected cases of small bowel obstruction. We describe a 77-year-old male patient with small bowel obstruction, and the cause of intestinal obstruction was proved by diagnostic laparoscopy to be a bezoar, which was fragmented and milked into the colon smoothly with laparoscopic instruments. The patient had an uneventful recovery and was discharged from the hospital 4 days later after the procedure. A review of the literature shows that laparoscopic management is an alternative to conventional surgery, either by a totally laparoscopic approach or a laparoscopic-assisted procedure. Minimally invasive surgery is not only an excellent diagnostic tool for bezoar-induced small bowel obstruction, but also in some selected cases, a choice of treatment.