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子宫回肠瘘临床虽较少见,但与剖宫产术有关,故应引起临床医生的重视。现将子宫回肠瘘早期修补成功1例报告如下。患者31岁,住院号8642。因足月妊娠临产,G_1P_o,臀位,足先露,于1986年7月22日在外院行剖宫产术。术后第2日感左下腹阵发性绞痛,腹胀明显,无呕吐发热。第3日排气排便,但腹痛腹胀无缓解。第5日出现高热,经抗感染治疗后体温降至正常。7日拆线,切口Ⅱ期愈合。术后8日,患者诉阴道内有排气感与虫钻感,并有粪臭样黄水流出,腹痛腹胀减轻。查体:腹部膨隆,左下腹压痛反跳痛,无肌紧张,阴道口见两条蛔虫及蛋花汤样便流出。诊断为剖宫产术后子宫回肠瘘。即在硬麻下行剖腹探查术,术中见左下腹及左髂凹处有稀粪约200ml,蛔虫50余条,该区小肠表面附有少量脓苔.肠壁充血水肿,距回盲瓣30cm 处回肠与子宫下段切口左侧粘连,轻易分离粘连后,见该处肠管有2cm 圆形破口,与之粘连的子宫切口裂开4cm。手术取出蛔虫,吸净粪液,冲
Although the clinical uterine ileal fistula is relatively rare, but related with cesarean section, it should attract the attention of clinicians. Now the early repair of the uterine ileum fistula 1 case reported as follows. Patient 31 years old, hospital number 8642. Due to full-term pregnancy labor, G_1P_o, breech, foot first dew, July 22, 1986 in the hospital cesarean section. On the 2nd postoperative sense of left lower extremity paroxysmal colic, abdominal distension was obvious, no vomiting fever. Exhaust on the 3rd day defecation, but abdominal pain without remission. High fever appeared on the 5th day and the body temperature dropped to normal after anti-infective treatment. On the 7th stitches, incision healed. On the 8th postoperative day, the patient v. Vomit had a sense of exhaust and worm drill, and fecal odor-like yellow water flowed out. The abdominal pain and abdominal distension were relieved. Examination: bulging abdomen, left lower quadrant tenderness rebound tenderness, no muscle tension, vaginal mouth see two roundworm and egg-like soup will flow out. Diagnosis of uterine ileal fistula after cesarean section. That is, under the laparotomy in hard cannabis surgery, see the left lower abdomen and left iliac recess have dung about 200ml, roundworm more than 50 articles, the area of the small intestine with a small amount of pus moss intestinal wall congestion and edema, from the ileocecal valve 30cm Department ileum and uterine incision on the left side of adhesions, easy separation of adhesions, see the Department there intestinal circular 2cm break, with the adhesions uterine incision 4cm. Surgical removal of roundworms, net absorption of manure, red