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Abstract：
A 39-year-old woman was admitted with colicky left upper-quadrant pain, dyspnoea, low-grade fever, tachycardia and a subtle left upper-quadrant tenderness without leucocytosis. Computed tomography revealed a distended gastric remnant due to small-bowel loop herniation at the trocar site. The patient underwent a diagnostic laparoscopy as her general condition worsened. Perforation across the staple line was seen and repaired. The postoperative period was uneventful. As a rare complication of laparoscopic Roux-en-Y gastric bypass, small-bowel obstruction is of great importance because it can lead to gastric remnant perforation if not managed correctly. There have been rare reports of trocar site herniation as a cause of small-bowel obstruction following laparoscopic Roux-en-Y gastric bypass. Prompt diagnostic laparoscopy should be considered. This is the first case reported in which the excluded stomach was perforated due to trocar site herniation of the small-bowel loop. It should be noted that the tissue around the perforation is fragile and proper tension should be employed when it is repaired. Generally, an omental patch is not encouraged.
摘要：
一名三十九岁女子因左上腹绞痛入院,呼吸困难,低烧,心动过速和轻微的左上腹压痛，无白细胞增多。计算机断层扫描显示，由于套管针部位的小肠loop疝，导致胃部残留扩张。由于患者的一般状况恶化，患者接受了诊断性腹腔镜检查。看到并修复了钉线上的穿孔。术后时间顺利。作为腹腔镜Roux-en-Y胃旁路术的罕见并发症，小肠梗阻是非常重要的，因为如果管理不正确，它可能导致残胃穿孔。很少有报道称，腹腔镜Roux-en-Y胃旁路术后套管针疝是小肠梗阻的原因。应考虑及时进行诊断性腹腔镜检查。这是第一例报道的病例，其中由于套管针部位小肠环突出而使排除的胃穿孔。应当注意的是,穿孔周围的组织是脆弱的,并且在修复时应当采用适当的张力。一般来说,不鼓励使用网膜修补。
