穿孔性胃肠道溃疡导致急性呼吸窘迫。
Perforated gastrointestinal ulcers presenting as acute respiratory distress.
机构信息
Department of Emergency Medicine, Rambam medical center, Haifa, Israel.
出版信息
World J Emerg Med. 2012;3(2):150-3. doi: 10.5847/wjem.j.issn.1920-8642.2012.02.013.
BACKGROUND
Dyspnea is one of the most common complaints facing the emergency medicine physician. Some of the gastrointestinal causes of dyspnea are self-limited and not life-threatening, yet others are, and early diagnosis and treatment are crucial.
METHODS
In this article we presented one of these life-threatening conditions through a clinical description of a patient presenting with acute respiratory distress that was finally diagnosed to be the result of a perforated gastric ulcer.
RESULTS
An emergent thoracotomy revealed a small ulcer with perforation in the fundus of the stomach. The patient was transferred after the operation to the intensive care unit and after a prolonged hospitalization discharged home. Biopsies taken from the ulcer showed diffuse inflammation, with no evidence of microorganisms or malignancy.
CONCLUSION
Perforation of gastric and duodenal ulcers is a rare yet existing cause of dyspnea and respiratory failure and should be kept in mind by the emergency physician, especially when other more common causes are ruled out.
背景
呼吸困难是急诊医生最常遇到的症状之一。一些导致呼吸困难的胃肠道疾病是自限性的，不会危及生命，但也有一些是致命的，早期诊断和治疗至关重要。
方法
本文通过对一名因急性呼吸窘迫而就诊的患者的临床描述，介绍了其中一种危及生命的情况，最终诊断为胃穿孔溃疡所致。
结果
紧急开胸手术显示胃底部有一个小溃疡穿孔。手术后，患者被转至重症监护病房，经过长时间住院治疗后出院回家。从溃疡处取的活检显示弥漫性炎症，无微生物或恶性证据。
结论
胃和十二指肠溃疡穿孔是一种罕见但确实存在的导致呼吸困难和呼吸衰竭的原因，急诊医生应牢记这一点，特别是在排除其他更常见的原因之后。
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