Clark Clair Louise Taylor, Murray Elspeth Victoria
Department of Anaesthetics, Borders General Hospital, Melrose, UK
Department of General Surgery, Borders General Hospital, Melrose, UK.
BMJ Case Rep. 2020 Mar 22;13(3):e233373. doi: 10.1136/bcr-2019-233373.
A 58-year-old woman presented to the emergency department in a district general hospital with severe abdominal pain and diarrhoea, after collapsing at home. She was admitted to the intensive care unit (ICU) in septic shock, and with acute kidney injury. An initial CT scan was suggestive of colitis. She was treated for suspected gastroenteritis and her microbiology results showed as the causative organism. She failed to respond to antibiotics, and underwent serial contrast CTs which showed no progression of colitis. Colonoscopy performed on day 10 of her admission, however, revealed fulminant colitis. After a multidisciplinary meeting among gastroenterologists, general surgeons and intensivists, the patient underwent total colectomy with ileostomy. She made a slow but steady recovery in ICU, and subsequently in the ward, and was discharged to a local community hospital for further rehabilitation.
一名58岁女性在家中晕倒后,因严重腹痛和腹泻被送往一家地区综合医院的急诊科。她因感染性休克和急性肾损伤被收入重症监护病房(ICU)。最初的CT扫描提示为结肠炎。她因疑似肠胃炎接受治疗,微生物学检查结果显示 为致病微生物。她对抗生素治疗无反应,后续的增强CT显示结肠炎无进展。然而,在入院第10天进行的结肠镜检查显示为暴发性结肠炎。在胃肠病学家、普通外科医生和重症监护医生进行多学科会诊后,患者接受了全结肠切除术并做了回肠造口术。她在ICU以及随后在病房中恢复缓慢但稳定,之后被转至当地社区医院进行进一步康复治疗。