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奥格利夫(Ogilvie)综合征:坦桑尼亚非机构中年女性获得性免疫缺陷综合征的特殊表现。

Ogilvie syndrome: peculiar manifestation of acquired immunodeficiency syndrome in non-institutionalized middle age female in Tanzania.

机构信息

Department of Radiology, The Aga Khan Hospital Dar es Salaam, Tanzania.

Department of Orthopaedics, Kilimanjaro Christian Medical Centre, Kilimanjaro, Tanzania.

出版信息

Pan Afr Med J. 2020 Dec 2;37:298. doi: 10.11604/pamj.2020.37.298.25252. eCollection 2020.

Abstract

Since it was first documented in 1948 by Sir William Heneage Ogilvie, numerous cases of Ogilvie syndrome have been described in literature due to various medical and surgical causes. Nonetheless, only a handful of cases only have been documented due to underlying Acquired Immunodeficiency Syndrome (AIDS). A 41-year-old female was admitted with an acute abdomen secondary to partial mechanical intestinal obstruction or paralytic ileus based on signs and symptoms and Abdominal X-Ray (AXR). She was known to be HIV/AIDS WHO clinical stage II on treatment. On diagnostic imaging studies she had distended large bowels without features of mechanical intestinal obstruction and the diagnosis of Ogilvie syndrome was suspected after other differentials were excluded. Early recognition and appropriate management are essential, because if left untreated the bowel distension may progress to caecal perforation and fatal peritonitis. Medical imaging with Computer Tomography (CT) scan and colonoscopy has helped in achieving an accurate diagnosis and avoiding unnecessary laparotomies. Although an uncommon disorder, for earlier and accurate diagnosis a high index of suspicion is required by clinicians and radiologists who are treating patients with underlying HIV/AIDS. Ogilvie's syndrome is a rare condition and if missed can be fatal. In patients with HIV/AIDS, the symptoms may be directly due to HIV infection, secondary to opportunistic infections or possible neurotoxic effects of HIV treatment or lack of vitamin and minerals. It is important to exclude Ogilvie syndrome in patients from surgical causes of the acute abdomen to avoid unnecessary surgical procedures.

摘要

自 1948 年由威廉·亨利·奥吉尔维爵士首次记录以来,由于各种医学和外科原因,文献中已经描述了许多奥吉尔维综合征病例。尽管如此,由于潜在的获得性免疫缺陷综合征(AIDS),仅有少数病例有记录。

一名 41 岁女性因急性腹痛入院,病因是部分机械性肠梗阻或麻痹性肠梗阻,依据是症状和体征以及腹部 X 光(AXR)。她已知是接受治疗的艾滋病病毒/艾滋病世界卫生组织临床阶段 II 期患者。在诊断性影像学研究中,她的大肠膨胀,但没有机械性肠梗阻的特征,排除其他鉴别诊断后,怀疑为奥吉尔维综合征。早期识别和适当的治疗至关重要,因为如果不治疗,肠膨胀可能进展为盲肠穿孔和致命性腹膜炎。计算机断层扫描(CT)扫描和结肠镜检查的医学影像学有助于做出准确的诊断并避免不必要的剖腹手术。

尽管奥吉尔维综合征并不常见,但治疗潜在艾滋病病毒/艾滋病患者的临床医生和放射科医生需要高度怀疑该疾病,以便更早、更准确地诊断。奥吉尔维综合征是一种罕见的疾病,如果漏诊可能是致命的。在艾滋病病毒感染者中,症状可能直接由 HIV 感染引起,也可能继发于机会性感染,或是 HIV 治疗的神经毒性作用或缺乏维生素和矿物质所致。在因外科原因导致急性腹痛的患者中,排除奥吉尔维综合征很重要,以避免不必要的手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2733/7881921/c919592f195b/PAMJ-37-298-g001.jpg

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