败血症与空肠间置术所致出血性溃疡：一例报告及文献综述
Septicemia and a Bleeding Ulcer of a Jejunal Interposition: A Case Report and Short Review of the Literature.
作者信息
Wild W, Bormann F, Sweiti H, Tamimi N, Pichulek D, Divo M, Dörr P, Schwarzbach M
机构信息
Department of General, Visceral, Vascular and Thoracic Surgery, Clinical Center Frankfurt Höchst, Frankfurt, Germany.
Department of Trauma and Orthopedic Surgery, BG Trauma Center, Frankfurt, Germany.
出版信息
Case Rep Med. 2018 Jan 22;2018:4278904. doi: 10.1155/2018/4278904. eCollection 2018.
INTRODUCTION
We report a case of septicemia in a patient presenting with a bleeding ulcer of a jejunal interposition.
CASE PRESENTATION
An 81-year-old female patient was acutely admitted to our hospital due to hematemesis and melena. She had a history of metastatic gastrointestinal stromal tumor, for which she was receiving second line treatment with sunitinib. She had also undergone a Merendino procedure 4 years prior to presentation. The patient underwent emergency gastroscopy, which revealed a bleeding ulcer in the jejunal interposition. Despite initial endoscopic control of the bleeding and transfusion of blood products, the hemoglobin level continued to drop, and the patient was treated for an assumed hemolytic transfusion reaction. The patient died 3 days following admission, and the results of blood cultures later confirmed a septicemia. The postmortem examination revealed a diffuse spread of to multiple organs.
CONCLUSION
This case is a reminder of the importance of considering septicemia, particularly in association with , as a potential cause of hemolysis. It also demonstrates the extent of organ involvement in a case of diffuse clostridial myonecrosis.
引言
我们报告一例患有空肠间置出血性溃疡患者的败血症病例。
病例介绍
一名81岁女性患者因呕血和黑便急症入院。她有转移性胃肠道间质瘤病史，正在接受舒尼替尼二线治疗。她在就诊前4年还接受了梅伦迪诺手术。患者接受了急诊胃镜检查，发现空肠间置有出血性溃疡。尽管最初通过内镜控制了出血并输注了血液制品，但血红蛋白水平持续下降，患者因假定的溶血性输血反应接受治疗。患者入院3天后死亡，血培养结果后来证实为败血症。尸检显示梭菌性肌坏死扩散至多个器官。
结论
该病例提醒我们，尤其是与[此处原文缺失相关内容]相关时，考虑败血症作为溶血潜在原因的重要性。它还展示了弥漫性梭菌性肌坏死病例中器官受累的程度。
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