小肠阻塞是由于迁移的食道金属支架
Soumyadip Sain1, Chirag Panara1, Suvendu Sekhar Jena1
1Institute of Surgical Gastroenterology, GI & HPB Onco-surgery and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India.
International journal of surgery case reports
|February 9, 2025
概括
用于食道穿孔的完全覆盖的自扩展金属支架 (FC-SEM) 可以迁移并导致肠道阻塞. 这一案例强调了需要仔细选择支架和密切跟踪患者,以防止严重的并发症,如需要手术的小肠阻塞.
科学领域:
- 胃肠病学 胃肠病学
- 最少侵入性的手术
- 医疗器械并发症 医疗器械并发症
背景情况:
- 内镜食道支架,包括完全覆盖的自扩展金属支架 (FC-SEMs),用于各种疾病,如癌症,狭窄和穿孔.
- 虽然FC-SEM通常是安全的,但存在迁移的风险,这可能导致严重的并发症,如肠道阻塞.
- 博尔哈夫综合征是一种自发的食道穿孔,越来越多地通过内镜干预,如SEM等进行管理.
研究的目的:
- 描述一种罕见的肠道阻塞病例,由迁移的食道支架引起.
- 强调与FC-SEMs相关的潜在并发症,特别是迁移诱导的小肠阻塞.
- 强调对患有食道支架的患者进行警的随访和管理策略的重要性.
主要方法:
- 一份病例报告显示,一名48岁的男性患有Boerhaave综合征,并接受了FC-SEM治疗.
- 患者在8个月后出现了肠道阻塞的症状.
- 通过成像检查确认了诊断,该成像显示了在阴茎中迁移的支架,随后在失败的保守管理后进行了手术检索.
主要成果:
- 一个完全覆盖的自我扩展的金属支架从食道迁移到中腹膜.
- 迁移的支架导致小肠阻塞.
- 手术探索和支架提取成功进行,恢复无故障.
结论:
- 迁移的FC-SEM,即便是用于食道疾病,也可能导致显著的胃肠道并发症,如小肠道阻塞.
- 这一案例凸显了仔细选择患者,选择适当的支架和认真进行术后监测的必要性.
- 个性化管理和及时干预,包括手术,对于解决食道支架迁移引起的严重并发症至关重要.
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