中暑治疗期间并发气肿性胆囊炎。
Emphysematous cholecystitis during the treatment of heat stroke.
作者信息
Yoshiyama Naomasa, Okada Hideshi, Miyake Takahito, Kitagawa Yuichiro, Fukuta Tetsuya, Yasuda Ryu, Matsuo Mikiko, Hatano Yuichiro, Tomita Hiroyuki, Yoshida Shozo, Ogura Shinji
机构信息
Department of Emergency and Disaster Medicine Gifu University Graduate School of Medicine Gifu Japan.
Fukuokaken Saiseikai Futsukaichi Hospital Fukuoka Japan.
出版信息
Acute Med Surg. 2020 Dec 12;7(1):e613. doi: 10.1002/ams2.613. eCollection 2020 Jan-Dec.
BACKGROUND
During a heat stroke, microvascular injury may occur as a result of thermal damage and systemic hypoperfusion. We present a case of an older woman who experienced emphysematous cholecystitis during a treatment of heat stroke.
CASE PRESENTATION
A 91-year-old woman presented unconscious with a blood pressure, pulse, and core temperature of 73/48 mmHg, 135 bpm, and 39.8°C, respectively. The patient was diagnosed with heat stroke. Twenty-two hours after arrival, the patient fell into septic shock. We diagnosed emphysematous cholecystitis and performed an emergency cholecystectomy. As the bile culture was positive for , meropenem was administered. The patient was transferred for rehabilitation 32 days after admission.
CONCLUSIONS
Emphysematous cholecystitis can present during a treatment of heat stroke. An abdominal X-ray examination should be performed during treatment of heat stroke in the acute phase regardless of the physical assessment.
背景
在中暑期间，微血管损伤可能由于热损伤和全身低灌注而发生。我们报告一例老年女性在中暑治疗期间发生气肿性胆囊炎的病例。
病例介绍
一名91岁女性昏迷入院，血压、脉搏和核心体温分别为73/48 mmHg、135次/分和39.8°C。该患者被诊断为中暑。入院22小时后，患者陷入感染性休克。我们诊断为气肿性胆囊炎并进行了急诊胆囊切除术。由于胆汁培养 呈阳性，给予美罗培南治疗。患者入院32天后转至康复科。
结论
气肿性胆囊炎可在中暑治疗期间出现。在中暑急性期治疗期间，无论体格检查结果如何，均应进行腹部X线检查。
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