Schapira B, Nazarian S, Thanapal M, Parmar C, Mukhtar H
University College London, UK.
Whittington Health NHS Trust, UK.
Ann R Coll Surg Engl. 2020 Oct;102(8):560-565. doi: 10.1308/rcsann.2020.0075. Epub 2020 Apr 24.
Necrotising enterocolitis (NEC) is a rare cause of the acute abdomen in adults and carries one of the highest mortality rates in gastroenterology. However, its rarity confines research to small case reports. Both its pathogenesis and aetiology remain enigmatic in adult patients, proving timely diagnosis and management a challenge. This paper reports on one case of NEC in an adult patient with underlying anorexia nervosa, following a seven-day period of starvation. She underwent emergency laparotomy for resection of necrotic bowel and subsequently made a good recovery. To date, there have only been eight reports linking NEC with anorexia nervosa. We review our patient in the context of plausible mechanisms hypothesised in these cases. Successful management depends on prompt diagnosis, resuscitation and surgical intervention.
坏死性小肠结肠炎（NEC）是成人急腹症的罕见病因，在胃肠病学领域死亡率极高。然而，其罕见性使得研究局限于小型病例报告。在成年患者中，其发病机制和病因仍不明朗，及时诊断和治疗颇具挑战。本文报告一例成年神经性厌食症患者在饥饿七天后发生NEC的病例。她接受了急诊剖腹手术以切除坏死肠段，随后恢复良好。迄今为止，仅有八篇关于NEC与神经性厌食症相关的报告。我们结合这些病例中假设的合理机制对该患者进行了回顾。成功治疗取决于及时诊断、复苏和手术干预。
