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腹腔镜治疗克罗恩病并发化脓性肝脓肿:一例报告

Laparoscopic treatment of pyogenic liver abscess complicating Crohn's disease: a case report.

作者信息

Baca Bilgi, Hamzaoğlu Ismail, Karahasanoğlu Tayfun, Hamzaoğlu Hülya Over

机构信息

Department of General Surgery, Istanbul University Cerrahpasa Medical School, Istanbul.

出版信息

Turk J Gastroenterol. 2007 Mar;18(1):58-61.

Abstract

Pyogenic liver abscess in patients with Crohn's disease is not common, but the mortality has been reported to be high if diagnosis or treatment is delayed. Herein, we report the case of a 42-year-old man in whom multi-locular liver abscess was encountered in the right lobe of the liver as a complication of Crohn's disease. On his admission to the emergency unit, he had right upper quadrant pain, fever of 39 degrees C and hepatomegaly. Ultrasonography and abdominal computerized tomography demonstrated multi-locular pyogenic liver abscess in the right lobe of the liver. Percutaneous drainage failed because of the density of the pus; laparoscopic exploration was subsequently performed and 1500 ml pus was successfully drained. The patient became clinically stable without fever and with a decreasing white blood cell count on the third postoperative day.

摘要

克罗恩病患者发生化脓性肝脓肿并不常见,但据报道,如果诊断或治疗延误,死亡率会很高。在此,我们报告一例42岁男性患者,其作为克罗恩病的并发症,在肝脏右叶出现了多房性肝脓肿。他入住急诊病房时,有右上腹疼痛、39摄氏度发热及肝肿大。超声检查和腹部计算机断层扫描显示肝脏右叶有多房性化脓性肝脓肿。由于脓液浓稠,经皮引流失败;随后进行了腹腔镜探查,成功引流了1500毫升脓液。术后第三天,患者临床症状稳定,不再发热,白细胞计数下降。

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