Subphrenic Free Air in a Patient after Percutaneous Endoscopic Gastrostomy: Report of a Case

經皮內視鏡胃造瘻術後併發腹腔游離氣：一病例報告

李忠憲(Chung-Hsien Li) ； 謝財源(Tsai-Yuan Hsien) ； 林煊淮(Hsuan-Hwai Lin) ； 朱恆成(Heng-Cheng Chu) ； 施銘朗(Ming-Lang Shih) ； 張維國(Wei-Kuo Chang)

《臺灣消化醫學雜誌》 24卷4期 (2007/12) Pp. 395-399

https://doi.org/10.6557/GJT.200712_24(4).0005

摘要

經皮內視鏡胃造瘻術，不經剖腹程序，僅需局部麻醉。目前該項技術已廣泛應用在長期管灌餵食之病患。腹腔游離氣是經皮內視鏡胃造瘻術常見的併發症。根據文獻報告，腹腔游離氣的發生率由8.6%至55.6%，其發生的原因與內視鏡產生高壓力或刺針穿透胃壁有關。我們報告一位60歲男性病患，因腦中風接受經皮內視鏡胃造瘻術。術後第4天，病患有發燒和腹痛；腹部理學檢查有上腹部壓痛，但無明顯腹膜炎症狀。胸部X光發現橫隔膜下有腹腔游離氣。病患接受胃管引流、禁食、抗生素、輸液和電解質補充後，症狀明顯改善。胸部X光於術後第13天；顯示腹腔游離氣已完全消失。

關鍵字

腹腔游離氣 ； 經皮內視鏡胃造瘻術 ； 內視鏡術 ； 管灌途徑

並列摘要

Feeding difficulties are common in neurologically impaired elderly patients. Percutaneous endoscopic gastrostomy (PEG) is a recently described as a nonoperative technique for establishing a safe route for long-term enteral feeding. It is well recognized that patients undergoing PEG may have pneumoperitoneum on subsequent radiographic studies. In most cases, however, pneumoperitoneum after PEG tube placement is considered to be a benign course without the need for aggressive surgical intervention. Surgical intervention is only required in the presence of peritonitis or hemodynamic instability. In this paper, we report a 60-year-old patient with pneumoperitoneum after PEG tube placement.

並列關鍵字

pneumoperitoneum ； percutaneous endoscopic gastrostomy ； endoscopy ； enteral access