Abstract：
Late perforation of the ileum is a rare and potentially life-threatening complication following intestinal resection. We present a unique case of a woman in her 60s with a history of appendiceal carcinoid tumour, who underwent a right hemicolectomy. Positron emission tomography and surveillance CTs showed normal surgical changes and no recurrent malignancy. Three years postoperatively, she presented with severe abdominal pain. CT revealed a perforation along the ileal wall of the ileocolonic anastomosis. She underwent emergent resection and repeat ileocolonic anastomosis. We conclude that the patient had subclinical ischaemia of the anastomosis, which eventually progressed to perforation 3 years later. We discuss a literature review on late small intestinal anastomotic perforations and their associated risk factors. Our case and literature review emphasise the importance of considering delayed anastomotic leak in postoperative patients with a history of intestinal cancer, inflammatory bowel disease, Roux-en-Y enteroenterostomy or side-to-side anastomosis.
摘要：
肠切除术后回肠穿孔是一种罕见且可能危及生命的并发症。我们介绍了一个60多岁的女性的独特病例，有阑尾类癌病史，做了右半结肠切除术.正电子发射断层扫描和监视CT显示正常的手术改变，没有复发的恶性肿瘤。术后三年,她出现了严重的腹痛。CT显示回肠结肠吻合术的回肠壁穿孔。她接受了紧急切除和重复回肠结肠吻合术。我们得出的结论是，患者患有吻合口的亚临床缺血，3年后最终进展为穿孔。我们讨论了有关小肠吻合口穿孔及其相关危险因素的文献综述。我们的病例和文献综述强调了在有肠癌病史的术后患者中考虑延迟吻合口漏的重要性。炎症性肠病，Roux-en-Y肠肠造口术或左右吻合术。
