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气腹与肠壁囊样积气,一种危险组合。病例报告

Pneumoperitoneum and Pneumatosis cystoides intestinalis, a dangerous mixture. A case report.

作者信息

Moyon Fernando X, Molina Gabriel A, Tufiño Jorge F, Basantes Veronica M, Espin Darwin S, Moyon Miguel A, Cevallos Jaime M, Palacios Néstor E, Parra Ruben A, Eras Karla R

机构信息

Department of General Surgery, Hospital General San Francisco, IESS Quito-Ecuador, Ecuador.

Colegio de Ciencias de la Salud, Universidad San Francisco de Quito USFQ, Quito, Ecuador.

出版信息

Int J Surg Case Rep. 2020;74:222-225. doi: 10.1016/j.ijscr.2020.07.086. Epub 2020 Aug 29.

Abstract

BACKGROUND

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by gas infiltration into the intestine wall. When gas is seen in the intestinal wall, it is usually a sign of bowel wall infarction and a surgical emergency; therefore, an adequate differentiation of benign and urgent conditions of pneumatosis intestinalis is necessary to prevent misdiagnosis and inadequate therapies.

CASE PRESENTATION

We present the case of a 79-year-old male with past medical history of Alzheimer's, cholecystectomy, and umbilical hernia. PCI was identified, and conservative therapy was started. Since the patient's pain persisted, a complication was suspected, and surgery was decided. After successful treatment, the patient completely recovered.

CONCLUSION

There are many benign and life-threatening causes of pneumatosis intestinalis, the imaging appearance of both may look very similar. Therefore, clinical history, physical examination, and laboratory test results are the best indicators of whether it is due to a benign or life-threatening cause. PCI must be managed with a multidisciplinary team of clinicians, radiologists, and surgeons to achieve better results for our patients.

摘要

背景

肠壁囊样积气症(PCI)是一种罕见疾病,其特征为气体渗入肠壁。当在肠壁中发现气体时,通常是肠壁梗死的迹象且属于外科急症;因此,有必要对肠壁积气症的良性和紧急情况进行充分鉴别,以防止误诊和治疗不当。

病例介绍

我们报告一例79岁男性患者,其既往有阿尔茨海默病、胆囊切除术和脐疝病史。确诊为PCI后,开始进行保守治疗。由于患者疼痛持续,怀疑有并发症,于是决定进行手术。经过成功治疗,患者完全康复。

结论

肠壁积气症有许多良性和危及生命的病因,两者的影像学表现可能非常相似。因此,临床病史、体格检查和实验室检查结果是判断其病因是良性还是危及生命的最佳指标。必须由临床医生、放射科医生和外科医生组成的多学科团队来管理PCI,以便为我们的患者取得更好的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c28/7484497/3988c8dd4530/gr1.jpg

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