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一名镰状细胞性状患者肠道和脾脏梗死的独特病因。

A unique cause of intestinal and splenic infarction in a sickle cell trait patient.

作者信息

Asfaw Sofya H, Falk Gavin A, Morris-Stiff Gareth, Tuthill Ralph J, Moorman Matthew L, Samotowka Michael A

机构信息

Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

出版信息

Case Rep Surg. 2013;2013:580453. doi: 10.1155/2013/580453. Epub 2013 May 7.

Abstract

Sickle-cell trait is a common genetic abnormality in the African American population. A sickle-cell crisis in a patient with sickle-cell trait is uncommon at best. Abdominal painful crises are typical of patients with sickle cell anemia. The treatment for an abdominal painful crisis is usually medical and rarely surgical. We present the case of a cocaine-induced sickle-cell crisis in a sickle-cell trait patient that resulted in splenic, intestinal, and cerebral infarctions and multisystem organ failure necessitating a splenectomy, subtotal colectomy, and small bowel resection. This case highlights the diagnostic dilemma that abdominal pain can present in the sickle-cell population and illustrates the importance of recognizing the potential for traditionally medically managed illnesses to become surgical emergencies.

摘要

镰状细胞性状是非洲裔美国人中常见的一种基因异常。患有镰状细胞性状的患者发生镰状细胞危象的情况极为罕见。腹部疼痛性危象是镰状细胞贫血患者的典型症状。腹部疼痛性危象的治疗通常采用药物治疗,很少进行手术治疗。我们报告了一例患有镰状细胞性状的患者因可卡因诱发镰状细胞危象,导致脾梗死、肠梗死和脑梗死以及多系统器官衰竭,需要进行脾切除术、次全结肠切除术和小肠切除术。该病例凸显了镰状细胞患者出现腹痛时的诊断困境,并说明了认识到传统药物治疗疾病有转变为外科急症可能性的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bef/3662113/ddd5d197c567/CRIM.SURGERY2013-580453.001.jpg

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