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腹膜后坏死性筋膜炎病例:一种罕见且致命的病症蔓延。

Case of retroperitoneal necrotising fasciitis: a rare and deadly spread.

作者信息

Ikram Saad, Satyapal Deepak, Kaur Geeta, Dabra Ajay

机构信息

General Surgery, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Scunthorpe, UK.

Department of Surgery, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Scunthorpe, UK.

出版信息

BMJ Case Rep. 2019 Apr 29;12(4):e228530. doi: 10.1136/bcr-2018-228530.

Abstract

Necrotising fasciitis (NF) is a potentially lethal spread of infection that is uncommonly seen within the province of surgery. Seen mostly in the extremities and the perineal regions, it has been reported rarely to involve the retroperitoneal space and presents with a spectrum of symptoms and signs as such. Literature supports classification of NF based on the microbes involved. Irrespective of the aetiology and the causative organism, NF remains a serious surgical emergency with high morbidity and mortality not only associated with the disease process itself, but also with the extensive surgical debridement it requires in its management along with antimicrobial administration. We present a case of such an infection found in the retroperitoneal space secondary to a perineal infection forming a rare presentation of this deadly process, and how it was successfully managed secondary to timely surgical intervention.

摘要

坏死性筋膜炎(NF)是一种潜在致命的感染扩散性疾病,在外科领域并不常见。它多见于四肢和会阴区域,很少有报道累及腹膜后间隙,且会表现出一系列相应的症状和体征。文献支持根据所涉及的微生物对NF进行分类。无论病因和致病生物是什么,NF仍然是一种严重的外科急症,不仅与疾病本身相关的高发病率和死亡率有关,而且与其治疗过程中所需的广泛外科清创以及抗菌药物的使用有关。我们报告了一例因会阴感染继发于腹膜后间隙的此类感染病例,这种感染是这种致命疾病的罕见表现,以及如何通过及时的手术干预成功治疗该病例。

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本文引用的文献

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Current concepts in the management of necrotizing fasciitis.坏死性筋膜炎治疗的当前概念
Front Surg. 2014 Sep 29;1:36. doi: 10.3389/fsurg.2014.00036. eCollection 2014.
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Early diagnosis of retroperitoneal necrotizing fasciitis.腹膜后坏死性筋膜炎的早期诊断
Crit Care Med. 2001 May;29(5):1071-3. doi: 10.1097/00003246-200105000-00040.
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