非闭塞性肠系膜缺血的并发症
Complications of non-occlusive mesenteric ischaemia.
作者信息
Weledji Elroy Patrick
机构信息
Department of Surgery Faculty of Health Sciences University of Buea Buea Southwest Region Cameroon.
出版信息
Acute Med Surg. 2015 Jun 15;3(1):50-52. doi: 10.1002/ams2.111. eCollection 2016 Jan.
CASE
A 65-year-old arteriopath with a history of myocardial infarction 5 months previously presented with classical signs of mesenteric infarction that led to a right hemicolectomy with an end ileostomy.
OUTCOME
Postoperative complications occurred due to unusually large volume ileostomy output in the subsequent 4 weeks, resulting in severe volume depletion and the sequelae that required intensive care support. These were triggered and prolonged by two episodes of intra-abdominal sepsis.
CONCLUSIONS
Sepsis-induced high ileostomy output following intestinal resection for non-occlusive mesenteric ischaemia is a serious complication. Early restoration of intestinal continuity following bowel resection for established infarction may prevent this complication.
病例
一名65岁的动脉病变患者，5个月前有心肌梗死病史，现出现肠系膜梗死的典型症状，接受了右半结肠切除术并进行了末端回肠造口术。
结果
术后4周，由于回肠造口排出量异常大，出现了术后并发症，导致严重的容量消耗以及需要重症监护支持的后遗症。两次腹腔内感染引发并延长了这些并发症。
结论
非闭塞性肠系膜缺血肠切除术后，脓毒症引起的回肠造口排出量增加是一种严重并发症。对于已确诊梗死的肠段切除术后早期恢复肠道连续性可能预防这种并发症。
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