急诊内镜下钛夹缝合治疗直肠穿孔1例

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

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。

To study the diagnosis and treatment of spontaneous rectal perforation.To retrospectively analyze and summarize the clinical data of an elderly patient with spontaneous rectal perforation in Chongqing University Fuling Hospital.The patient was admitted with intermittent bloody stools and abdominal pain,and had a history of coronary arteriosclerosis,rapid atrial fibrillation,multiple cerebral infarction,and chronic obstructive pulmonary disease.Fever,tenderness and rebound pain in the lower abdomen were present on admission.Emergency endoscopy was performed to diagnose rectal perforation with bleeding.After multi-disciplinary evaluation,change the position of the fistula under emergency endoscopy to make it in a high position.After flushing the fistula,the fistula was successfully clamped with titanium clips.After 8 days of anti-inflammatory treatment,the patient was cured and discharged.