Takemura Keisuke, Sekoguchi Satoru, Yamane Satoki, Yamaguchi Katsutoshi, Oaku Tatsuro, Hotta Yuma, Yamada Nobuhisa, Isozaki Yutaka, Nagao Yasuyuki, Oyamada Hirokazu, Maeda Kazuki, Itou Tetsuya
Department of Gastroenterology, Matsushita Memorial Hospital.
Department of Clinical Laboratory, Matsushita Memorial Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2018;115(6):554-562. doi: 10.11405/nisshoshi.115.554.
An 80-year-old man had a medical history of chronic hepatitis C and pancreatoduodenectomy. We detected recurrence of hepatocellular carcinoma, and performed transcatheter arterial chemoembolization, instead of radiofrequency ablation or surgery, because of the patient's medical history of bile duct reconstruction and liver dysfunction. On the second day, he was diagnosed with a gas-forming liver abscess and underwent liver abscess drainage. Clostridium perfringens and sordellii were detected by aspiration and the blood culture. Meropenem and Clindamycin were administered intravenously. He was treated shortly after the occurrence before the involvement of severe hemolysis and recovered from the acute phase.
一名80岁男性有慢性丙型肝炎和胰十二指肠切除术病史。我们检测到肝细胞癌复发，由于患者有胆管重建和肝功能障碍病史，故行肝动脉化疗栓塞术，而非射频消融或手术。术后第二天，他被诊断为产气性肝脓肿并接受了肝脓肿引流。通过抽吸和血培养检测到产气荚膜梭菌和索氏梭菌。静脉给予美罗培南和克林霉素。在严重溶血发生前不久进行治疗，患者从急性期康复。
