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腹腔镜治疗鱼刺经胃壁刺入肝脏所致化脓性肝脓肿:1例报告

Laparoscopic treatment of pyogenic liver abscess caused by fishbone puncture through the stomach wall and into the liver: A case report.

作者信息

Kadi Abudureyimu, Tuergan Talaiti, Abulaiti Yierpan, Shalayiadang Paizula, Tayier Baihetiyaer, Abulizi Abududuaini, Tuohuti Muniremu, Ahan Ayifuhan

机构信息

Department of Hepatobiliary and Hydatid Disease, Digestive and Vascular Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.

Department of General Medicine, First People's Hospital of Aksu Region, Aksu 843099, Xinjiang Uygur Autonomous Region, China.

出版信息

World J Clin Cases. 2022 Dec 26;10(36):13402-13407. doi: 10.12998/wjcc.v10.i36.13402.

Abstract

BACKGROUND

Pyogenic liver abscess (PLA) due to foreign body penetration of the gastrointestinal tract is rare but can lead to serious consequences if not diagnosed and managed properly. We report a case of PLA caused by a fishbone puncture.

CASE SUMMARY

This report describes the clinical features, diagnosis and treatment of a 56-year-old male patient who presented with severe pneumonia, acute respiratory failure and septic shock. The main clinical manifestation was a nonspecific recurrent infection. Based on the findings of abdominal computed tomography examination and the detailed medical history, the diagnosis was made as PLA which was caused by fishbone puncture through the stomach wall and into the liver. After active anti-inflammatory treatment, the patient's general condition had improved. The laparoscopic drainage of the liver abscess and the foreign body removal was performed. There was no recurrence of abscess at discharge or during follow-up and the patient's general condition was satisfactory.

CONCLUSION

PLA caused by foreign bodies usually requires surgical treatment or percutaneous drainage combined with antibiotics. Our case confirms that a laparoscopic approach is safe and feasible for such cases.

摘要

背景

胃肠道异物穿透导致的化脓性肝脓肿(PLA)较为罕见,但如果诊断和处理不当,可能会导致严重后果。我们报告一例由鱼刺穿刺引起的PLA病例。

病例摘要

本报告描述了一名56岁男性患者的临床特征、诊断和治疗过程,该患者表现为严重肺炎、急性呼吸衰竭和感染性休克。主要临床表现为非特异性反复感染。根据腹部计算机断层扫描检查结果和详细病史,诊断为PLA,由鱼刺穿过胃壁刺入肝脏所致。经过积极抗炎治疗,患者的一般状况有所改善。进行了肝脓肿的腹腔镜引流及异物取出术。出院时及随访期间脓肿均未复发,患者一般状况良好。

结论

异物引起的PLA通常需要手术治疗或经皮引流联合使用抗生素。我们的病例证实,腹腔镜方法对此类病例是安全可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7b3/9850996/b0866ed0346e/WJCC-10-13402-g001.jpg

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