Lillegard Joseph B, Porterfield John R
Department of Surgery, Mayo Clinic, Rochester, Minn., USA.
Case Rep Gastroenterol. 2010 Feb 27;4(1):79-83. doi: 10.1159/000262290.
In this case report we detail the difficult case of a 74-year-old male patient who was transferred to our cardiac intensive care unit in severe shock with an acute abdomen. His abdomen was emergently explored revealing isolated gastric necrosis and ischemia. A subtotal gastrectomy was performed and the patient was discharged from the hospital 34 days after surgery. Postoperatively we learned that for the preceding 2 weeks the patient had doubled the dose of Forcalide syrup which he had been taking for his reactive airway disease for many years. Formal testing of this fluid revealed a concentrated sugar-based solution with a high concentration of both Ephedra and potassium chloride. Final pathology of the resected stomach demonstrated patent vessels to the stomach with extensive microvascular thrombosis and full-thickness gastric necrosis. On final summation of this case we concluded that the Ephedra in the patient's Forcalide syrup caused the microvascular necrosis seen in the stomach and should be added to the list of potential adverse reactions seen with the ingestion of ephedrine.
在本病例报告中，我们详细介绍了一名74岁男性患者的疑难病例，该患者因急腹症处于严重休克状态被转入我们的心脏重症监护病房。他的腹部被紧急探查，发现孤立的胃坏死和缺血。进行了胃次全切除术，患者术后34天出院。术后我们了解到，在之前的2周里，患者将服用多年的用于治疗反应性气道疾病的福卡利德糖浆剂量加倍。对这种液体进行的正式检测显示，这是一种浓缩的含糖溶液，麻黄碱和氯化钾浓度都很高。切除胃的最终病理显示，胃部血管通畅，但有广泛的微血管血栓形成和全层胃坏死。在对该病例进行最终总结时，我们得出结论，患者福卡利德糖浆中的麻黄碱导致了胃部所见的微血管坏死，应将其列入摄入麻黄碱后可能出现的不良反应清单。
