METHODS: A 31-year-old woman at 38 weeks of gestation with a history of five cesarean sections presented with lower abdominal pain following a tonic-clonic epileptic seizure. Emergency surgery was performed due to fetal distress, and the uterus was found to be ruptured. After delivering the baby and closing the uterus, a drainage tube was inserted into the pouch of Douglas. Two days after surgery, the right ampulla and infundibulum were eviscerated from the drain site during the drainage tube removal. A second surgery was performed to reduce the herniated uterine tube.
UNASSIGNED: Drainage tubes are typically easily removed without complications. Some reported complications related to drainage tube removal include herniation, anchoring and suctioning of the uterine tube to the drainage tube, knotting with the colonic epiploica, and fracturing and retraction of the drainage tube due to adhesions. To the best of our knowledge, this is the first reported case of uterine tube evisceration during drainage tube removal.
CONCLUSIONS: Evisceration after drainage tube removal is very rare. We believe that this is the first report of immediate evisceration after the removal process. Such complications can be avoided with more restricted instructions for the use of drainage tubes and more researches on the reasons for these complications.
方法:一名31岁女性,妊娠38周,有五次剖宫产史,在强直阵挛性癫痫发作后出现下腹痛。因胎儿窘迫进行了急诊手术,发现子宫破裂了.分娩并关闭子宫后,一根引流管插入道格拉斯的袋子里。手术两天后,在移除引流管时,右壶腹和漏斗从引流部位取出内脏。进行了第二次手术以减少突出的子宫管。
■引流管通常很容易取出而不会出现并发症。一些报道的与引流管拔除有关的并发症包括疝,将子宫管固定和抽吸到引流管上,与结肠表观打结,以及由于粘连导致的引流管破裂和缩回。据我们所知,这是首例报道的引流管拔除过程中子宫管内脏取出的病例。
结论:引流管拔除后内脏损伤非常罕见。我们认为,这是清除过程后立即取出内脏的第一份报告。通过对引流管的使用进行更严格的说明以及对这些并发症的原因进行更多的研究,可以避免这种并发症。