RESUMEN
An 86-year-old woman who suffered from cardiac tamponade due to acute Stanford type A aortic dissection was admitted to our hospital. An emergency operation was performed uneventfully. She suffered from abdominal pain 13 days after the operation. Computed tomography( CT) scan revealed pericholecystic fluid and unclear gallbladder wall, revealing acalculous necrotizing cholecystitis. We performed open cholecystectomy and abdominal cavity drainage. No gallstones were observed. She underwent intensive treatment. She was discharged without complications 44 days after the cholecystectomy.
Asunto(s)
Disección Aórtica , Vesícula Biliar , Femenino , Humanos , Anciano , Anciano de 80 o más Años , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/cirugía , Tomografía Computarizada por Rayos X , NecrosisRESUMEN
A 76-year-old man with thoracic aortic aneurysm was admitted to our hospital. Aortic arch replacement was performed uneventfully. He suffered from abdominal pain 17 days after the operation. Computed tomography (CT) scan revealed a strangulated bowel obstruction, and we performed emergent open abdominal surgery. During the operation, we found an adhesion between the greater omentum and the retroperitoneum. The small intestine was intussuscepted into this site, and strangulated with necrosis of a 35-cm length. We performed a partial resection of the small intestine. We encountered rare strangulated bowel obstruction after open heart surgery due to adhesion of the great omentum in a patient without a history of abdominal surgery.
Asunto(s)
Aorta Torácica , Obstrucción Intestinal , Masculino , Humanos , Anciano , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugía , Obstrucción Intestinal/diagnóstico por imagen , Obstrucción Intestinal/etiología , Obstrucción Intestinal/cirugía , Hernia Interna , Intestino Delgado/diagnóstico por imagen , Intestino Delgado/cirugía , Intestino Delgado/patología , Adherencias Tisulares , Necrosis/etiologíaRESUMEN
PURPOSE: Inguinal and femoral hernias are common disorders associated with aging. Incarcerated external hernias, however, are often fatal. This study investigated the prognostic factors in patients with incarcerated hernias. METHODS: The study reviewed 38 patients (aged 35-97 years) diagnosed with incarcerated hernias who underwent emergency surgery. The patients were divided into those with or without a small intestinal resection, and they were then analyzed according to time from onset of symptoms to surgery. RESULTS: The time from symptom onset to surgery was significantly longer in the resection group than in the group without resection. The patients were divided into those treated within or after 12 h using a receiver-operating characteristic curve. A sensitivity of 71.4% and a specificity of 83.4% were obtained using the time from symptom onset to operation of 12 h as a cutoff value. More patients who underwent surgery after 12 h from the onset of symptoms required an intestinal resection. Patients who underwent surgery later than 12 h after the onset of symptoms also stayed in the hospital longer than those operated on within 12 h. CONCLUSIONS: The amount of time that elapses from the onset of symptom to surgery is considered to be an important prognostic factor in patients with incarcerated hernias. Early diagnosis and early treatment are therefore necessary in such patients.