Delayed Onset of Intestinal Injury after Laparoscopic Assisted Vaginal Hysterectomy: A Case Report

在執行腹腔鏡輔助經陰道行全子宮切除時引發小腸傷害的病例報告

曾仁宇(Jen-Yu Tseng) ； 王鵬惠(Peng-Hui Wang)

《The Kaohsiung Journal of Medical Sciences》 15卷12期 (1999/12) Pp. 715-719

https://doi.org/10.6452/KJMS.199912.0715

摘要

因為腹腔鏡輔助的婦科手術已經逐年在增加，所以有關於腹腔鏡手術的併發症也越來越被注意到。大部份的併發症發生在手術中，其中絕大部份都立即被發現，而此些病例因為及時的處置，也都有極佳的預後。在此，本文報告一個病例，內容敘述病人在接受腹腔鏡輔助經陰道行全子宮切除時，引發電燒造成的小腸延遲性傷害，因為症狀不明顯未能立即且適當的修補，病人在手術後一週才發現，雖經處置，病人仍不治死亡。雖然直接的死亡原因可能與此無關，但是藉由本文的文獻回顧以及作者之經驗，將可能的預防方法作一討論，期盼拋磚引玉避免日後再發生，或是降低至最低。

並列摘要

Because of the increasing popularity of laparoscopic surgery for gynecological diseases, it is inevitable that complications from such procedures will become more common. The majority of complications occur during operation where they are immediately identified and managed; recovery and outcome are relatively good after immediate repair. However, there are still a few cases that are not diagnosed until severe complications become evident. Herein, we report a relatively rare complication - a delayed onset of small intestinal perforation detected one week after initial laparoscopic assisted vaginal hysterectomy. Although we performed an emergent exploratory laparotomy to repair this complication, the patient died of uncontrolled sepsis and possible sudden onset of arrhythmia. Through a review of the literature, possible mechanisms of this complication are discussed. In addition, we hope that this case review will help avoid such complications in the future.

並列關鍵字

complication ； laparoscopic surgery