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消化系统源性人工髋关节感染:一种罕见但严重疾病的诊断——病例报告

Prosthetic Hip Joint Infection of Digestive Origin, Diagnosis of a Rare but Serious Condition: A Case Report.

作者信息

Popescu David, Espino Pauline Gonzalez, Cauter Maïté Van, Geerts Pierre, Cornu Olivier

机构信息

Department of Orthopaedic Surgery, Cliniques Universitaires de Saint Luc, Belgium.

Department of Orthopedic Surgery, Centre Hospitaller Regional du Val de Sambre, Belgium.

出版信息

J Orthop Case Rep. 2023 Jul;13(7):140-144. doi: 10.13107/jocr.2023.v13.i07.3786.

Abstract

INTRODUCTION

Prosthetic joint infection (PJI) is a relatively infrequent occurrence; however, it always poses a significant risk to the patient's functional outcome. The origin of PJI is often a topic of debate. In this case, we present a PJI that resulted from a digestive fistula passing through an iliopsoas abscess, which can be regarded as an unusual consequence of rare conditions.

CASE REPORT

A 72-year-old man was brought to the emergency department with pain in his right hip and a functional impairment of his right lower limb. This had been ongoing for 3 weeks and he had no history of trauma or fever. An initial X-ray was negative for fracture, but a computed tomography scan showed a large collection of liquid and gas in his psoas major muscle extending to the right prosthetic hip. The origin of the collection was from the digestive tract. It was caused by his fistula that brought the intestinal lumen in contact with the patient's prosthetic hip through the psoas major muscle and caused a PJI.

CONCLUSION

The interconnectivity of various medical disciplines is exemplified by this case, where a digestive fistula resulted in an infection of a prosthetic hip. It is essential for both the orthopedic and general surgeons to recognize that a digestive fistula can pose a threat to a prosthetic hip.

摘要

引言

人工关节感染(PJI)相对少见;然而,它始终对患者的功能预后构成重大风险。PJI的起源常常是一个争论的话题。在此病例中,我们呈现了一例由穿过髂腰肌脓肿的消化瘘导致的PJI,这可被视为罕见情况的不寻常后果。

病例报告

一名72岁男性因右髋部疼痛及右下肢功能障碍被送至急诊科。这种情况持续了3周,他没有外伤或发热史。最初的X线检查未发现骨折,但计算机断层扫描显示其腰大肌内有大量液气积聚,延伸至右侧人工髋关节。积液的来源是消化道。是他的瘘管导致肠腔通过腰大肌与患者的人工髋关节接触并引发了PJI。

结论

本病例体现了各医学学科之间的相互联系,即消化瘘导致了人工髋关节感染。骨科医生和普通外科医生都必须认识到消化瘘会对人工髋关节构成威胁。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a224/10379262/95f340e88e0c/JOCR-13-140-g001.jpg

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