1例直肠脱垂患者自发性直肠穿孔的病例报告  

Spontaneous rectal perforation in a patient with rectal prolapse:a case report

作　　者：伍伟明 唐生众 唐耿忠 王常箐 陈功波 苏丹[2,3] 任东林 Wu Weiming;Tang Shengzhong;Tang Gengzhong;Wang Changqing;Chen Gongbo;Su Dan;Ren Donglin(Department of Colorectal Surgery,Zhangjiajie People's Hospital,Zhangjiajie 427000,Hunan,China;Department of Colorectal Surgery,The Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou 510655,Guangdong,China;Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,Guangzhou 510655,Guangdong,China)

机构地区：[1]张家界市人民医院肛肠外科,湖南张家界427000 [2]中山大学附属第六医院肛肠外科,广东广州510655 [3]广东省结直肠盆底疾病研究重点实验室,广东广州510655

出　　处：《结直肠肛门外科》2024年第2期173-176,共4页Journal of Colorectal & Anal Surgery

摘　　要：对于直肠脱垂的患者而言,围手术期往往需要行机械性肠道准备,包括清洁灌肠和口服泻剂等,一是为了行结肠镜检查以排除肠道息肉、肿瘤等肠道病变,二是为了术前行肠道清洁准备以便术后顺利康复。但是直肠脱垂患者本身存在因反复脱垂引起的肠壁脆性增高、肠壁缺血、变薄等解剖缺陷,存在潜在自发性穿孔的风险。直肠穿孔是直肠脱垂最严重的并发症之一,需要急诊处理,本文总结并反思1例直肠脱垂患者行机械性肠道准备时诱发自发性直肠穿孔病例的诊治经过,供同行引起警惕及参考。For patients with rectal prolapse,mechanical bowel preparation,including cleansing enemas and oral laxatives,is often required during the perioperative period.This preparation serves two purposes:one is to perform colonoscopy to exclude intestinal polyps,tumors,and other intestinal lesions,and the other is to cleanse the bowel before surgery to facilitate smooth recovery after surgery.However,patients with rectal prolapse inherently have anatomical defects such as increased fragility of the intestinal wall,intestinal wall ischemia and thinning due to repeated prolapse,which pose a potential risk of spontaneous perforation.Rectal perforation is one of the most severe complications of rectal prolapse and requires emergency treatment.This article summarizes and reflects on the diagnosis and treatment of a case of spontaneous rectal perforation induced by mechanical bowel preparation in a patient with rectal prolapse,providing a warning and reference for colleagues.

关 键 词：直肠脱垂 自发性直肠穿孔 机械性肠道准备 

分 类 号：R657.1[医药卫生—外科学]