截瘫患者的结肠梗阻：一种不常见病因引起的常见症状。
Colonic obstruction in a tetraplegic patient: a common symptom from an uncommon cause.
机构信息
Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
出版信息
Spinal Cord Ser Cases. 2020 Jun 29;6(1):53. doi: 10.1038/s41394-020-0305-6.
INTRODUCTION
It is difficult to diagnose an acute abdomen condition in people with spinal cord injury due to abnormal sensation below the injured level and multiple co-morbidities. These issues can mislead the exact diagnosis and delay proper treatment.
CASE PRESENTATION
A 57-year-old male with C4 AIS C tetraplegia developed nausea and vomiting, abdominal distension and feeding intolerance. Serum electrolytes indicated severe hyponatremia. A provisional diagnosis of pseudo-gut obstruction was made. After the failure of 48 h of conservative treatment with a nasogastric and rectal tube, abdominal CT was performed and revealed sigmoid volvulus.
CONCLUSIONS
Due to the inconclusive clinical features and lack of subjective complaints, early use of CT scan or MRI is preferable in people with SCI who are suspected of an emergency intra-abdominal condition.
简介
由于损伤水平以下感觉异常和多种合并症，脊髓损伤患者的急性腹痛情况难以诊断。这些问题可能会导致误诊，并延误适当的治疗。
病例介绍
一名 57 岁男性，C4 AIS C 四肢瘫痪，出现恶心、呕吐、腹胀和喂养不耐受。血清电解质提示严重低钠血症。初步诊断为假性肠梗阻。经鼻胃管和直肠管 48 小时保守治疗失败后，进行了腹部 CT 检查，结果显示乙状结肠扭转。
结论
对于疑似有紧急腹部情况的脊髓损伤患者，由于临床表现不明确且缺乏主观症状，应尽早使用 CT 扫描或 MRI。
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