Takano Yuichi, Tanaka Hiroaki, Kawamo Michiari, Sasaki Jun, Hayashi Munetaka
Department of Critical Care and Emergency Medicine Showa University Fujigaoka Hospital Yokohama Kanagawa Japan.
Division of Gastroenterology Department of Internal Medicine Showa University Fujigaoka Hospital Yokohama Kanagawa Japan.
Acute Med Surg. 2015 Jul 22;3(2):143-146. doi: 10.1002/ams2.146. eCollection 2016 Apr.
A 38-year-old mentally retarded woman was transported to the emergency room for marked undernutrition. Two months prior, she had developed tooth decay and her food intake decreased severely. Over 2 months, her weight decreased from 47 to 31 kg (-16 kg). Computed tomography (CT) revealed extensive subcutaneous, mediastinal, and retroperitoneal emphysema. She was hospitalized and treatment with central venous hyperalimentation and antibiotics was initiated. CT performed 3 weeks after hospitalization showed that the systemic emphysema had completely disappeared.
She progressed favorably and was transferred to a specialized psychiatric hospital for further treatment.
Regardless of the cause, this rare complication must be taken into account when treating patients suffering from long-term starvation or undernutrition. Whole-body management including nutritional management and careful follow-up observations are appropriate for treating this condition.
一名38岁的智障女性因严重营养不良被送往急诊室。两个月前，她出现了龋齿，食物摄入量严重减少。在两个多月的时间里，她的体重从47公斤降至31公斤（减轻了16公斤）。计算机断层扫描（CT）显示广泛的皮下、纵隔和腹膜后气肿。她住院治疗，开始进行中心静脉高营养和抗生素治疗。住院3周后进行的CT检查显示全身气肿已完全消失。
她病情好转，被转至一家专门的精神病医院接受进一步治疗。
无论病因如何，在治疗长期饥饿或营养不良的患者时，都必须考虑到这种罕见的并发症。包括营养管理和仔细的随访观察在内的全身管理措施适用于治疗这种疾病。
