局限性肠炎中的腹腔内脓肿
Intra-abdominal abscess in regional enteritis.
作者信息
Ribeiro M B, Greenstein A J, Yamazaki Y, Aufses A H
机构信息
Department of Surgery, Mount Sinai School of Medicine, City University of New York, New York.
出版信息
Ann Surg. 1991 Jan;213(1):32-6. doi: 10.1097/00000658-199101000-00006.
Intra-abdominal abscess (IAA) developed in 129 of 610 patients (21.2%) with Crohn's disease confined to the small bowel. The location of the abscess was intraperitoneal (IPA) in 109 (17.9%) and retroperitoneal (RPA) in 20 (3.3%). There was a marked preponderance of male patients in the retroperitoneal group (ratio, 18:2) (p less than 0.0001). All 129 patients were operated on. Thirteen of one hundred nine patients (12%) with IPA were reoperated on for recurrent abscess, and nine (8.2%) for other reasons. External fistula developed in 24 patients (22%) after simple incision and drainage. Four (3.7%) died; one from hepatitis, and three from sepsis 5, 14, and 90 days after surgery. Of the 20 patients with RPA, two (10%) were reoperated on for recurrent abscess and four (20%) for other reasons. External fistula developed in two patients (10%). There were no deaths in this group. A small number of patients with IAA complicating regional enteritis had persistent sepsis causing postoperative death, which is, however, six times lower than in our comparable series of Crohn's (ileo)colitis.
610例局限于小肠的克罗恩病患者中，129例（21.2%）发生了腹腔内脓肿（IAA）。脓肿位于腹膜内（IPA）的有109例（17.9%），位于腹膜后（RPA）的有20例（3.3%）。腹膜后组男性患者明显居多（比例为18:2）（p<0.0001）。所有129例患者均接受了手术。109例IPA患者中有13例（12%）因脓肿复发接受了再次手术，9例（8.2%）因其他原因接受了再次手术。单纯切开引流后，24例患者（22%）发生了外瘘。4例（3.7%）死亡；1例死于肝炎，3例分别于术后5天、14天和90天死于脓毒症。20例RPA患者中，2例（10%）因脓肿复发接受了再次手术，4例（20%）因其他原因接受了再次手术。2例患者（10%）发生了外瘘。该组无死亡病例。少数IAA合并局限性肠炎的患者持续发生脓毒症导致术后死亡，不过，这一比例比我们类似的克罗恩（回肠）结肠炎系列病例低6倍。
Zotero 插件