基于计算机断层扫描评估的腐蚀性食管炎病例的成功保守治疗
Successful conservative management of a case of caustic esophagitis based on computed tomography assessment.
作者信息
Yonemaru Hiroki, Karimata Hiroyuki, Shimoji Hideaki, Yamamoto Kei, Hanashiro Kazuhiko, Fukami Masataka, Ouchi Gen, Tamaki Yuichiro, Kondo Yutaka, Kukita Ichiro
机构信息
Nakagami Hospital Okinawa Okinawa Japan.
First Department of Surgery Graduate School of Medicine University of the Ryukyus Nishihara Okinawa Japan.
出版信息
Acute Med Surg. 2015 Aug 3;3(2):147-151. doi: 10.1002/ams2.149. eCollection 2016 Apr.
CASE
We describe the case of a female patient who ingested approximately 100 mL of toilet bowl cleaner containing 9.5% hydrochloric acid in a suicide attempt. Upon admission for hematemesis and epigastric pain, she was alert and oriented with stable vital signs. Initial contrast-enhanced computed tomography (CT) demonstrated edematous changes with no evidence of upper gastrointestinal tract perforation. Endoscopy was not performed owing to the high risk of perforation. We managed this patient conservatively. Repeat contrast-enhanced CT revealed mediastinal emphysema on day 2, which resolved by day 6. The patient was subsequently discharged with no apparent strictures of the upper gastrointestinal tract.
OUTCOME
Surgical interventions are frequently required following the ingestion of large amounts of highly concentrated hydrochloric acid; however, this patient was successfully managed conservatively.
CONCLUSION
Contrast-enhanced CT is useful in the assessment of the respiratory and digestive systems and the prediction of potential complications.
病例
我们描述了一名女性患者的病例，该患者为自杀而摄入了约100毫升含有9.5%盐酸的马桶清洁剂。因呕血和上腹部疼痛入院时，她意识清醒、定向力正常，生命体征稳定。初次增强计算机断层扫描（CT）显示有水肿改变，未发现上消化道穿孔迹象。由于穿孔风险高，未进行内镜检查。我们对该患者进行了保守治疗。重复增强CT显示第2天出现纵隔气肿，第6天消退。该患者随后出院，上消化道无明显狭窄。
结果
摄入大量高浓度盐酸后通常需要手术干预；然而，该患者通过保守治疗成功治愈。
结论
增强CT有助于评估呼吸和消化系统以及预测潜在并发症。
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