Tsai Ming-Kai, Chen I-Hung, Wang Chih-Chiang, Shiang Jeng-Chuan
Division of Nephrology, Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
Intern Med. 2010;49(22):2473-6. doi: 10.2169/internalmedicine.49.3614. Epub 2010 Nov 15.
Although reduced intestinal blood flow causing barrier dysfunction and endotoxemia is well documented in the pathogenesis of heat stroke (HS), complications of the gastrointestinal tract are less appreciated in HS patients. Herein, we report the case of a young man with exertional HS complicated with colon perforation. Acute abdomen, bloody diarrhea, dilated bowel loop, and unexplained shock should be considered as warning signs of colonic ischemia and consequent perforation. Early recognition is the key factor for improving the outcome of HS patients complicated with colon perforation.
虽然在热射病(HS)发病机制中,肠道血流减少导致屏障功能障碍和内毒素血症已有充分记载,但HS患者胃肠道并发症却较少受到重视。在此,我们报告一例年轻男性劳力性HS并发结肠穿孔的病例。急腹症、血性腹泻、肠袢扩张和不明原因休克应被视为结肠缺血及随后穿孔的警示信号。早期识别是改善HS并发结肠穿孔患者预后的关键因素。