经皮肾镜碎石取石术并发回肠损伤1例报告并文献复习

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ABSTRACT：ObjectiveTo investigate the clinical characteristics，diagnosis and treatment of ileal injurysecondary to percutaneous nephrolithotomy percutaneous nephrolithotomy（PCNL）.MethodsThe diagnosis and treatment of a patient were reviewed，and relevant literature were retrieved.ResultsThe patient was a41-year-old male，who underwent stage PCNL（initial percutaneousnephrostomy，folowed bysecondaryPCNL）due torightureteral calculi withsevere hydronephrosis.Onpostoperativeday1，hedevelopedabdominaldistensionandpain．Abdominal X-rayrevealed subdiaphragmatic free gas，and CT showedpelvicandabdominal fluidandgasaccumulation，suggesting peritonitis due to intestinal perforation.Emergency exploratory laparotomy identified a 3mm×3mm ileal perforation approximately 30cm from theileocecalvalve，whichwasrepaired surgically.The patientrecoveredwelland was dischargedafterone week，with no discomfortreported duringa 6-month follw-up.Conclusion The clinical featuresof ileal injurysecondaryto PCNL include earlypostoperativeabdominaldistension，painand peritonitis.Diagnosis reliesonclinical manifestations，abdominal X-rayand CT，with surgical exploration if necesary.Conservative managementundervigilantobservationcan becautiouslyadopted for localized injuries，while surgical repair is required for peritonitis or failed conservative therapy.

KEY WORDS：upper urinary tract stones；percutaneous nephrolithotomy；complications；ileal injury；smallintestinal injury摘要：目的探讨经皮肾镜碎石取石术（PCNL）并发回肠损伤的临床特点、诊断方法及治疗策略。（剩余8400字）