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找出不可能的:零碎的冷陷切除穿孔穿孔
Hyun Jae Kim1, Douglas Motomura1,2, Eric C S Lam1,2
1Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
概括
大型结直肠多瘤的片段冷陷切除 (CSR) 很少会导致穿孔. 切除部位的仔细评估至关重要,即使没有电,也可以识别潜在的深壁损伤.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 结肠直肠癌 预防 预防
背景情况:
- 切片冷陷切除 (CSR) 是用于大型非形结直肠多的常见技术.
- 虽然CSR通常是安全的,但具有很少发生穿孔的风险.
- 这一案例凸显了CSR过程中的程序内穿孔.
研究的目的:
- 报告一个罕见的过程内穿孔在零碎冷陷切除 (CSR) 过程中的案例.
- 在企业社会责任程序中强调彻底切除基评估的重要性.
主要方法:
- 一名63岁的克罗恩病患者接受了结肠直肠多的监测.
- 用10毫米的冷陷和染色注射剂对两个大型0-IIA横横结肠多进行了切片的CSR.
- 粘膜下染色体检查发现了深层壁面损伤,并用透视镜剪贴进行治疗.
主要成果:
- 在零碎的CSR过程中发现了IV型深壁损伤,尽管没有电.
- 通过内镜剪切成功处理了受伤.
- 患者在没有延迟不良事件的情况下恢复.
结论:
- 穿孔是一种罕见的,但可能是零碎冷陷切除 (CSR) 的并发症.
- 内镜医生必须进行细致的切除基评估,因为缺少体可以掩盖深壁损伤.
- 早期识别和内镜管理是有利结果的关键.
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