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[胆汁淤积的罕见原因:吗啡诱导的胆汁淤积]

[An infrequent cause of cholestasis: morphine-induced cholestasis].

作者信息

Canullan Carlos, Du Plessis María Cristina, Merchan Del Hierro Pablo, Quesada Bernabe, Petracchi Enrique

机构信息

Hospital General de Agudos Dr. Cosme Argerich.

Htal Gral de Agudos Dr. Cosme Argerich.

出版信息

Rev Fac Cien Med Univ Nac Cordoba. 2022 Sep 16;79(3):277-279. doi: 10.31053/1853.0605.v79.n3.33738.

Abstract

INTRODUCTION

Extrahepatic cholestasis by opiates is a very rare entity of which only case reports are recorded in the literature.

METHODS

We present the case of a patient who developed abdominal pain and cholestasis after consumption of high doses of morphine for pain management of her underlying disease, treated by laparoscopic surgery.

RESULTS

The patient evolved favorably in the postoperative period without bilirrhage and was discharged on the fifth day with bilirubin values ​​within normal parameters.

CONCLUSION

Sphincter of Oddi dysfunction syndrome secondary to long-term use of opioids is a very rare entity. However, it should be suspected in cases of extrahepatic cholestasis in which no stones or tumors are observed and in patients with long-term use of high-dose opiates either due to addiction or chronic pain treatment.

摘要

引言

阿片类药物引起的肝外胆汁淤积是一种非常罕见的病症,文献中仅记录有病例报告。

方法

我们报告一例患者,其在因基础疾病疼痛管理而服用高剂量吗啡后出现腹痛和胆汁淤积,通过腹腔镜手术进行治疗。

结果

患者术后恢复良好,未发生出血,术后第五天出院,胆红素值在正常范围内。

结论

长期使用阿片类药物继发的Oddi括约肌功能障碍综合征是一种非常罕见的病症。然而,在未观察到结石或肿瘤的肝外胆汁淤积病例以及因成瘾或慢性疼痛治疗而长期使用高剂量阿片类药物的患者中应怀疑此病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4eb/9590829/034e6f633f43/1853-0605-79-3-277-g001.jpg

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