Endoscopic repair of delayed stomach perforation caused by penetrating trauma:A case report  

作　　者：Jae Hyun Yoon Chung Hwan Jun Jae Pil Han Ji-Woong Yeom Seung-Ku Kang Hyun Yi Kook Sung KyuChoi 

机构地区：[1]Department of Gastroenterology and Hepatology,Chonnam National University Hospital and College of Medicine,Gwangju 61469,South Korea [2]Department of Internal Medicine,Mokpo Hankook Hospital,Mokpo 58643,South Korea [3]Department of Surgery,Mokpo Hankook Hospital,Mokpo 58643,South Korea [4]Department of Cardiothoracic Surgery,Mokpo Hankook Hospital,Mokpo 58643,South Korea [5]Department of Nursing,Chonnam National University Hospital,and College of Nursing,Gwangju 61469,South Korea

出　　处：《World Journal of Clinical Cases》2021年第5期1228-1236,共9页世界临床病例杂志

基　　金：Supported by Chonnam National University Hospital Biomedical Research Institute,No.BCRI19258.

摘　　要：BACKGROUND Primary endoscopic closure of a perforated gastric wall during endoscopic procedures is mostly effective and well-tolerated;however,there are very few studies on the efficacy of endoscopic management of delayed traumatic gastric perforation.Herein,we report a novel case of a patient who was successfully treated for delayed traumatic stomach perforation using an alternative endoscopic modality.CASE SUMMARY A 39-year-old woman presented with multiple penetrating traumas in the back and left abdominal cavity.Initial imaging studies revealed left diaphragmatic disruption and peri-splenic hemorrhage without gastric perforation.An emergency primary repair of the disrupted diaphragm with omental reduction and suturing of the lacerated lung was performed;however,delayed free perforation of the gastric wall was noted on computed tomography after 3 d.Following an emergency abdominal surgery for the primary repair of the gastric wall,re-perforation was noted 15 d postoperatively.The high risk associated with re-surgery prompted an endoscopic intervention using 2 endoloops and 11 endoscopic clips using a novel modified purse-string suture technique.The free perforated gastric wall was successfully repaired without additional surgery or intervention.The patient was discharged after 46 d without any complications.CONCLUSION Endoscopic closure with endoloops and clips can be a useful therapeutic alternative to re-surgery for delayed traumatic gastric perforation.

关 键 词：Surgical endoscopy TRAUMA STOMACH Re-perforation ENDOLOOP Case report 

分 类 号：R656.61[医药卫生—外科学]