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罕见的术后并发症:择期腹部手术后发生感染性休克。

Rare postoperative complication: septic shock following elective abdominal surgery.

作者信息

Bath Michael, McKelvie Mark, Canna Khalid

机构信息

Department of General Surgery, Bedford Hospital NHS Trust, Bedford, UK.

School of Clinical Medicine, University of Cambridge, Cambridge, UK.

出版信息

BMJ Case Rep. 2017 Oct 9;2017:bcr-2017-221980. doi: 10.1136/bcr-2017-221980.

Abstract

Postoperative infections are one of the most common complications in general surgery, and while rates have reduced with the routine administration of perioperative antibiotics, around 5% of patients undergoing a surgical procedure will develop an infective complication. The Gram-positive, obligate anaerobe, , is a well-known pathogen that forms part of both the environmental and gastrointestinal flora. While more commonly associated with food poisoning, anaerobic cellulitis and traumatic gas gangrene, rare cases of spontaneous non-traumatic gas gangrene of abdominal viscera have also been recorded. Although potentially treatable with appropriate antibiotic cover, cases of can rapidly progress into fulminant and fatal sepsis. Moreover, the timing of symptom onset postoperatively can vary significantly, reports ranging from hours to days. We report a case of induced septic shock following elective bowel resection.

摘要

术后感染是普通外科最常见的并发症之一,虽然围手术期常规使用抗生素后感染率有所降低,但仍有大约5%接受外科手术的患者会发生感染性并发症。革兰氏阳性专性厌氧菌是一种著名的病原体,它是环境菌群和胃肠道菌群的一部分。虽然它更常与食物中毒、厌氧性蜂窝织炎和创伤性气性坏疽相关,但也有罕见的腹部脏器自发性非创伤性气性坏疽病例记录。尽管使用适当的抗生素覆盖可能可以治疗,但病例可能会迅速发展为暴发性和致命性脓毒症。此外,术后症状出现的时间差异很大,报告显示从数小时到数天不等。我们报告一例择期肠切除术后诱发感染性休克的病例。

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