胰头切除术后猝死：梭菌感染导致肝动脉破裂。
Sudden death after pancreatic head resection: rupture of hepatic artery caused by clostridial infection.
作者信息
Königsrainer Ingmar, Kurth Ralf, Haack Birgit, Braun Alexander, Marschal Matthias, Heininger Alexandra, Bültmann Burkhard, Königsrainer Alfred
机构信息
Department of General, Visceral and Transplant Surgery, Tübingen University Hospital, Tübingen, Germany.
出版信息
Surg Infect (Larchmt). 2007 Dec;8(6):615-9. doi: 10.1089/sur.2006.068.
BACKGROUND
Rupture of the hepatic artery caused by clostridial infection has not been reported before.
METHODS
Case report and literature review.
RESULTS
A 75 year-old man was admitted to the hospital for resection of a cystic tumor of the head of the pancreas. A pylorus-preserving radical pancreaticoduodenectomy was performed. On the fifth postoperative day, he developed fever (38.2 degrees C), and computed tomography scanning revealed free air in the subhepatic area near the pancreaticojejunal anastomosis. On the ninth postoperative day, the patient died suddenly. Autopsy revealed a ruptured hepatic artery secondary to clostridial infection.
CONCLUSIONS
Close monitoring and early recourse to invasive diagnostic and therapeutic procedures may be advisable in the presence of suspect findings after pancreatic surgery to prevent this fatal complication.
背景
梭菌感染导致肝动脉破裂此前未见报道。
方法
病例报告及文献复习。
结果
一名75岁男性因胰头囊性肿瘤切除术入院。行保留幽门的根治性胰十二指肠切除术。术后第5天，患者发热（38.2℃），计算机断层扫描显示胰肠吻合口附近肝下区域有游离气体。术后第9天，患者突然死亡。尸检显示梭菌感染继发肝动脉破裂。
结论
胰腺手术后出现可疑发现时，密切监测并尽早采取侵入性诊断和治疗措施，可能有助于预防这一致命并发症。
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