Phillips Michael R, Erickson Kimberly M, Adamson William T, McLean Sean E
Division of Pediatric Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Am Surg. 2014 Sep;80(9):844-5.
A term male infant with Hirschsprung's disease underwent an uncomplicated laparoscopic-assisted endorectal pull-through procedure. Four weeks after discharge, the patient developed severe Clostridium difficile enterocolitis with hemodynamic instability and peritonitis. Bedside laparotomy confirmed intestinal viability and accommodated an appendicostomy for antegrade vancomycin colonic irrigations. The patient required venoarterial extracorporeal membrane oxygenation for physiological support for more than six days. Transition to conventional support was successful with survival and discharge from the hospital free from hemorrhagic complications. The patient is now developmentally appropriate for his age.
一名患有先天性巨结肠症的足月男婴接受了一次无并发症的腹腔镜辅助经肛门拖出术。出院四周后，该患者出现了严重的艰难梭菌性小肠结肠炎，并伴有血流动力学不稳定和腹膜炎。床边剖腹探查术证实肠道存活，并进行了阑尾造口术以便进行顺行万古霉素结肠灌洗。该患者需要静脉-动脉体外膜肺氧合进行超过六天的生理支持。成功过渡到传统支持治疗，患者存活并出院，无出血并发症。该患者目前的发育与年龄相符。
