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乳房坏疽。

Breast gangrene.

机构信息

Department of General Surgery, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.

出版信息

World J Emerg Surg. 2011 Aug 19;6:29. doi: 10.1186/1749-7922-6-29.

DOI:10.1186/1749-7922-6-29
PMID:21854557
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3173289/
Abstract

BACKGROUND

Breast gangrene is rare in surgical practice. Gangrene of breast can be idiopathic or secondary to some causative factor. Antibiotics and debridement are used for management. Acute inflammatory infiltrate, severe necrosis of breast tissue, necrotizing arteritis, and venous thrombosis is observed on histopathology. The aim of was to study patients who had breast gangrene.

METHODS

A prospective study of 10 patients who had breast gangrene over a period of 6 years were analyzed

RESULTS

All the patients in the study group were female. Total of 10 patients were encountered who had breast gangrene. Six patients presented with breast gangrene on the right breast whereas four had on left breast. Out of 10 patients, three had breast abscess after teeth bite followed by gangrene, one had iatrogenic trauma by needle aspiration of erythematous area of breast under septic conditions. Four had history of application of belladonna on cutaneous breast abscess and had then gangrene. All were lactating female. Amongst the rest two were elderly, one of which was a diabetic who had gangrene of breast and had no application of belladonna. All except one had debridement under cover of broad spectrum antibiotics. Three patients had grafting to cover the raw area.

CONCLUSION

Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement.

摘要

背景

乳房坏疽在外科实践中很少见。乳房坏疽可能是特发性的,也可能是由某些致病因素引起的。治疗方法是使用抗生素和清创术。组织病理学观察到急性炎症浸润、乳腺组织严重坏死、坏死性动脉炎和静脉血栓形成。目的是研究患有乳房坏疽的患者。

方法

对 6 年内患有乳房坏疽的 10 例患者进行前瞻性研究。

结果

研究组的所有患者均为女性。共发现 10 例乳房坏疽患者。6 例患者右乳房发生乳房坏疽,4 例患者左乳房发生乳房坏疽。10 例患者中,3 例因牙齿咬伤后出现乳房脓肿继而发生坏疽,1 例因在有感染的情况下对红斑区域进行针吸导致医源性创伤。4 例曾有在皮肤乳房脓肿上应用颠茄的病史,随后发生坏疽。所有患者均为哺乳期女性。其余 2 例为老年患者,其中 1 例为糖尿病患者,患有乳房坏疽,且未使用颠茄。所有患者均在广谱抗生素覆盖下进行清创术。3 例患者进行植皮覆盖创面。

结论

乳房坏疽很少见。病因多种多样,且多因素相关。哺乳期的牙齿咬伤和未在无菌条件下对乳房脓肿进行针吸可能是致病因素。未控制的糖尿病可能是乳房坏疽的另一个致病因素。颠茄作为一种局部应用药物可能是激发因素。有时乳房坏疽可能是特发性的。治疗方法是抗生素和清创术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da3/3173289/c66d705d946f/1749-7922-6-29-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da3/3173289/7b1f590e02d9/1749-7922-6-29-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da3/3173289/ecb53f8fe4ed/1749-7922-6-29-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da3/3173289/eaa4a6721ce6/1749-7922-6-29-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da3/3173289/787d9d62b308/1749-7922-6-29-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da3/3173289/c66d705d946f/1749-7922-6-29-5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da3/3173289/7b1f590e02d9/1749-7922-6-29-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da3/3173289/ecb53f8fe4ed/1749-7922-6-29-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da3/3173289/eaa4a6721ce6/1749-7922-6-29-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da3/3173289/787d9d62b308/1749-7922-6-29-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da3/3173289/c66d705d946f/1749-7922-6-29-5.jpg

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本文引用的文献

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Cases Illustrative of the Influence of Belladonna.体现颠茄影响的病例
Atlanta Med Surg J. 1861 Apr;6(8):459-463.
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Breast gangrene in an HIV-positive patient.一名HIV阳性患者发生乳腺坏疽。
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First report of a necrotising fasciitis of the breast following a core needle biopsy.首例经皮穿刺活检后发生乳腺坏死性筋膜炎的报告。
一例因感染灶继发心房颤动并发坏死性乳腺筋膜炎的误诊漏诊病例报告及文献简要回顾
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