Thakur Ajit, Elliott Brittney, Naik Rohan, Khan Nabeel, McQuaid Shayna, Arsene Camelia
Department of Internal Medicine, Sinai-Grace Hospital, Detroit Medical Center/Wayne State University School of Medicine, Detroit, Michigan, USA.
Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
BMJ Case Rep. 2018 Jan 4;2018:bcr-2017-222375. doi: 10.1136/bcr-2017-222375.
Hemicorporectomy, or translumbar amputation, is a radical surgery involving the dissection of the body at the waist and is usually reserved for complex medical conditions including locally invasive malignancy and terminal pelvic osteomyelitis. Only 71 cases have previously been reported. We present a rare case of hemicorporectomy in a 53-year-old patient with terminal pelvic osteomyelitis which occurred after he suffered a gunshot wound at T6 causing paraplegia at the age of 31. Unfortunately, this patient continued to suffer recurrent hospitalisations and sepsis events secondary to chronic, non-healing advanced pressure ulcers and complicated urinary tract infections despite repeated courses of broad-spectrum intravenous antibiotics and surgical debridements. In light of his diminished quality of life and poor prognosis, the patient's family chose to manage his condition conservatively with home hospice. This case illustrates the significant challenges in the medical and surgical management of hemicorporectomy patients.
半体切除术，即经腰部截肢术，是一种涉及在腰部对身体进行解剖的根治性手术，通常用于治疗包括局部侵袭性恶性肿瘤和终末期骨盆骨髓炎在内的复杂病症。此前仅报道过71例。我们报告了一例罕见的半体切除术病例，患者为一名53岁患有终末期骨盆骨髓炎的男性，他在31岁时因T6椎体枪伤导致截瘫。不幸的是，尽管多次使用广谱静脉抗生素并进行手术清创，但该患者仍因慢性、不愈合的晚期压疮和复杂的尿路感染而反复住院和发生败血症事件。鉴于其生活质量下降且预后不佳，患者家属选择在家中接受临终关怀来保守治疗其病情。该病例说明了半体切除术患者在医疗和手术管理方面面临的重大挑战。
