腹膜透析患者出现绿色透析液与胆囊穿孔：一例报告及文献综述
Green dialysate and gallbladder perforation in a peritoneal dialysis patients: a case report and literature review.
作者信息
Wu Yueh-Lin, Lin Yi-Sheng, Hsueh Thomas Yu-Ren, Lo Wen-Ching, Peng Kuo-Chou, Kao Mu-Jung
机构信息
Department of Nephrology, Taipei City Hospital, Zhongxiao Branch, No. 87, Tongde Road, Nangang District, Taipei, 115, Taiwan.
Division of Urology, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan.
出版信息
BMC Nephrol. 2018 Jul 4;19(1):165. doi: 10.1186/s12882-018-0974-6.
BACKGROUND
Gallbladder perforation is a rare but lethal condition and its diagnosis is usually difficult and delayed. Frequently, gallbladder rupture is associated with cholecystitis, but spontaneous perforation was ever described. However, spontaneous rupture of gallbladder has never been reported in patients underwent peritoneal dialysis.
CASE PRESENTATION
We report a 62-year-old man who presented with abdominal pain for 2 days to clinic. Peritoneal dialysis-related peritonitis was diagnosed initially. It was followed by spontaneous gallbladder perforation with greenish dialysate. The patient was managed successfully by antibiotic treatment and primary closure of gallbladder perforation with external drainage. He recovered from this critical condition and stayed on dialysis.
CONCLUSIONS
Early diagnosis and timely surgical intervention yields a good prognosis in PD patients with gallbladder perforation. Surgical intervention and antibiotic treatment are the mainstay of treatment. Both of them should take place promptly.
背景
胆囊穿孔是一种罕见但致命的疾病，其诊断通常困难且延迟。胆囊破裂常与胆囊炎相关，但也有自发性穿孔的报道。然而，腹膜透析患者从未有过胆囊自发性破裂的报告。
病例介绍
我们报告一名62岁男性，因腹痛2天前来就诊。最初诊断为腹膜透析相关性腹膜炎，随后出现胆囊自发性穿孔，透析液呈绿色。患者通过抗生素治疗及胆囊穿孔一期缝合加外引流成功治愈。他从危急状况中康复并继续接受透析治疗。
结论
对于胆囊穿孔的腹膜透析患者，早期诊断和及时的手术干预可带来良好预后。手术干预和抗生素治疗是主要治疗方法，两者均应迅速进行。
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