由……引起的暴发性假膜性小肠结肠炎：一例尸检病例报告
Fulminant pseudomembranous enterocolitis caused by : an autopsy case report.
作者信息
Nagamura Tatsunori, Tanaka Yoshihiro, Terayama Takero, Higashiyama Daishi, Seno Soichiro, Isoi Naoaki, Katsurada Yuka, Matsubara Akiko, Yoshimura Yuya, Sekine Yasumasa, Akitomi Shinji, Sato Kimiya, Tsuda Hitoshi, Saitoh Daizoh, Ikeuchi Hisashi
机构信息
Department of Traumatology and Critical Care Medicine National Defense Medical College Saitama Japan.
Department of Diagnostic Pathology Self-Defence Forces Central Hospital Tokyo.
出版信息
Acute Med Surg. 2018 Oct 24;6(1):78-82. doi: 10.1002/ams2.370. eCollection 2019 Jan.
CASE
We describe a rare case of antibiotic-associated fulminant pseudomembranous enterocolitis caused by . A 79-year-old man with a history of antibiotic therapy was admitted to our emergency department, complaining of consciousness disturbance. Initially, we suspected septic shock and diabetic ketoacidosis caused by intestinal infection. Although we administered sufficient extracellular fluid, his blood pressure was not elevated and his abdomen gradually swelled.
OUTCOME
The patient died of shock and abdominal compartment syndrome. Autopsy revealed widespread jejunal necrosis in conjunction with colitis, suggesting fulminant pseudomembranous enterocolitis caused by infection.
CONCLUSION
As the clinical features of pseudomembranous enterocolitis caused by resemble the features of colitis caused by , conservative therapy is applied first. However, fulminant pseudomembranous enterocolitis is a lethal disease, necessitating early operation for resection of the necrotic lesion. This report highlights the need for better surgical criteria at an early stage.
病例
我们描述了一例由……引起的罕见的抗生素相关性暴发性伪膜性小肠结肠炎病例。一名有抗生素治疗史的79岁男性因意识障碍入住我们的急诊科。最初，我们怀疑是由肠道感染引起的感染性休克和糖尿病酮症酸中毒。尽管我们给予了足够的细胞外液，但他的血压并未升高，且腹部逐渐肿胀。
结果
患者死于休克和腹腔间隔室综合征。尸检显示空肠广泛坏死并伴有结肠炎，提示由……感染引起的暴发性伪膜性小肠结肠炎。
结论
由于由……引起的伪膜性小肠结肠炎的临床特征与由……引起的结肠炎的特征相似，因此首先采用保守治疗。然而，暴发性伪膜性小肠结肠炎是一种致命疾病，需要早期手术切除坏死病变。本报告强调了在早期制定更好的手术标准的必要性。
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