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单纯结肠镜下息肉切除术后发生致命性坏死性筋膜炎:一例报告

Fatal Necrotizing Fasciitis Following Uncomplicated Colonoscopic Polypectomy: A Case Report.

作者信息

Chae Min Kyu, Shin Sang Youn, Kwak Min Seob, Yoon Jin Young, Kim Ha Il, Cha Jae Myung

机构信息

Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.

出版信息

Clin Endosc. 2021 Mar;54(2):280-284. doi: 10.5946/ce.2020.117. Epub 2020 Dec 11.

Abstract

Necrotizing fasciitis (NF) is a life-threatening infection that can be caused by various procedures or surgery and may develop in healthy elderly patients. Here, we report a case of a 66-year-old man with diabetes mellitus who underwent colonoscopic polypectomy, without complications. However, he visited the emergency department 24 hours after the procedure complaining of abdominal pain. Abdominopelvic computed tomography revealed multiple air bubbles in the right lateral abdominal muscles. After a diagnosis of NF was made, immediate surgical debridement was performed. However, despite three sessions of extensive surgical debridement and best supportive care at the intensive care unit, the patient died because of sepsis and NF-associated multiple-organ failure. In conclusion, physicians should pay special attention to the possibility of NF if a patient with risk factors for NF develops sepsis after colonoscopic polypectomy.

摘要

坏死性筋膜炎(NF)是一种危及生命的感染,可由各种操作或手术引起,也可能在健康的老年患者中发生。在此,我们报告一例66岁的糖尿病男性患者,他接受了结肠镜息肉切除术,术后无并发症。然而,术后24小时他因腹痛前往急诊科就诊。腹盆腔计算机断层扫描显示右侧腹外侧肌肉有多个气泡。在确诊为NF后,立即进行了手术清创。然而,尽管在重症监护病房进行了三次广泛的手术清创和最佳支持治疗,患者仍因败血症和NF相关的多器官功能衰竭死亡。总之,如果有NF危险因素的患者在结肠镜息肉切除术后发生败血症,医生应特别注意NF的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/425b/8039750/adcf43c6668e/ce-2020-117f1.jpg

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