Khajeh Fatemeh, Safari Fatemeh, Seyyedi Noorossadat, Asadian Fatemeh, Farhadi Ali, Behzad-Behbahani Abbas
Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Fasa University of Medical Sciences, Fasa, Iran.
Case Rep Gastroenterol. 2022 Mar 25;16(1):129-134. doi: 10.1159/000521719. eCollection 2022 Jan-Apr.
Gastric perforation as a multi-etiological disease is a full-thickness injury of the stomach wall. In this case report, we presented a 60-year-old woman with a history of suicidal behavior referred to the emergency unit with a decreased level of consciousness due to the multidrug consumption (amphetamine and benzodiazepine). Passing 3 days of admission in the intensive care unit, the patient represented severe abdominal distension, lack of defecation, and the absence of bowel sound, which suggested the gastrointestinal (GI) complication. Abdominal-pelvic sonography followed by laparotomy confirmed the gastric perforation, which finally led to the patient's death. Pathological analysis showed that the vast involvement of cytomegalovirus (CMV) in the patient's GI tract resulted in several peptic ulcers. The first report of gastric perforation-related death arises from the partnership of CMV infection and drug poisoning.
胃穿孔作为一种多病因疾病,是胃壁的全层损伤。在本病例报告中,我们介绍了一名60岁有自杀行为史的女性,因服用多种药物(苯丙胺和苯二氮卓类)导致意识水平下降,被送往急诊室。在重症监护病房住院3天后,患者出现严重腹胀、无排便及肠鸣音消失,提示存在胃肠道并发症。腹部盆腔超声检查后进行剖腹手术,证实为胃穿孔,最终导致患者死亡。病理分析显示巨细胞病毒(CMV)广泛累及患者胃肠道,导致多处消化性溃疡。首例与胃穿孔相关的死亡报告源于CMV感染与药物中毒的共同作用。