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成人坏死性小肠结肠炎——猪霍乱病:伦敦的一种源自太平洋地区的疾病。

Adult necrotising enterocolitis-pig-bel disease: a Pacific disease in London.

作者信息

Wormald Justin Conrad Rosen, Dindyal Sanjay, Mellor Francesca, Behar Nebil

机构信息

Department of Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.

出版信息

BMJ Case Rep. 2016 Oct 28;2016:bcr2016217903. doi: 10.1136/bcr-2016-217903.

Abstract

Adult necrotising enterocolitis secondary Clostridium perfringens type C-pig-bel disease-is rarely seen outside of Pacific populations, with the highest incidence being in Papau New Guinea. We present the first reported case of pig-bel disease in a previously well patient without diabetes following food poisoning since 1996. In this case, the enterotoxin-induced disease necessitated emergency laparotomy and bowel resection following the failure of medical treatment and worsening septic shock. We hypothesise that obstruction secondary to a sigmoid diverticular stricture complicated by infection-related oedema led to colonic stasis and rapid progression of disease and bowel loss. Following bowel resection, several parenteral antibiotic agents and prolonged intensive care, this patient survived this severe infective process and was discharged home.

摘要

成人坏死性小肠结肠炎继发于产气荚膜梭菌C型(猪霍乱)——在太平洋地区以外的人群中很少见,发病率最高的是巴布亚新几内亚。我们报告了自1996年以来首例在无糖尿病的既往健康患者中发生食物中毒后出现猪霍乱的病例。在该病例中,肠毒素引起的疾病在药物治疗失败且感染性休克恶化后需要进行紧急剖腹手术和肠切除。我们推测,乙状结肠憩室狭窄继发梗阻并伴有感染相关水肿导致结肠淤滞,疾病迅速进展并导致肠坏死。经过肠切除、多种肠外抗生素治疗及长时间的重症监护,该患者在这场严重的感染过程中存活下来并出院回家。

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