急诊内镜下钛夹缝合治疗直肠穿孔1例

段香梅, 罗萍, 况晶, 等. 急诊内镜下钛夹缝合治疗直肠穿孔1例[J]. 临床急诊杂志, 2022, 23(9): 674-676. doi: 10.13201/j.issn.1009-5918.2022.09.013
引用本文: 段香梅, 罗萍, 况晶, 等. 急诊内镜下钛夹缝合治疗直肠穿孔1例[J]. 临床急诊杂志, 2022, 23(9): 674-676. doi: 10.13201/j.issn.1009-5918.2022.09.013
DUAN Xiangmei, LUO Ping, KUANG Jing, et al. Treatment of rectal perforation with titanium splint under emergency endoscope: a case report[J]. J Clin Emerg, 2022, 23(9): 674-676. doi: 10.13201/j.issn.1009-5918.2022.09.013
Citation: DUAN Xiangmei, LUO Ping, KUANG Jing, et al. Treatment of rectal perforation with titanium splint under emergency endoscope: a case report[J]. J Clin Emerg, 2022, 23(9): 674-676. doi: 10.13201/j.issn.1009-5918.2022.09.013

急诊内镜下钛夹缝合治疗直肠穿孔1例

  • 基金项目:
    重庆市卫生健康委员会资助项目(No:2019jstg007)
详细信息

Treatment of rectal perforation with titanium splint under emergency endoscope: a case report

More Information
  • 回顾性分析重庆大学附属涪陵医院收治的1例自发性直肠穿孔老年患者的临床资料,并进行总结分析。患者因间断血便伴腹痛收治入院,既往有冠状动脉粥样硬化性心脏病、快速性心房纤颤、多发脑梗死、慢性阻塞性肺疾病等病史。入院时患者发热,下腹部压痛、反跳痛,急诊内镜检查诊断直肠穿孔伴出血。经多学科评估后,予以急诊内镜下钛夹缝合治疗,治疗过程中变换体位使瘘口处于高位,充分冲洗瘘口后,钛夹夹闭瘘口成功,后经消炎治疗8 d,治愈出院。
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  • 图 1  急诊内镜手术过程及CT检查

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出版历程
收稿日期:  2021-11-14
刊出日期:  2022-09-10

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