Dong Zhen-Yu, Shi Rui-Xian, Song Xiao-Biao, Du Ming-Yue, Wang Ji-Jun
Department of General Surgery, Baotou Central Hospital, Baotou 014040, Inner Mongolia Autonomous Region, China.
Department of General Surgery, Baotou Medical College, Baotou 014040, Inner Mongolia Autonomous Region, China.
World J Clin Cases. 2024 Feb 26;12(6):1138-1143. doi: 10.12998/wjcc.v12.i6.1138.
Intestinal obstruction is a common occurrence in clinical practice. However, the occurrence of herpes zoster complicated by intestinal obstruction after abdominal surgery is exceedingly rare. In the diagnostic and treatment process, clinicians consider it crucial to identify the primary causes of its occurrence to ensure effective treatment and avoiding misdiagnosis.
Herein, we present the case of a 40-year-old female patient with intestinal obstruction who underwent laparoscopic appendectomy and developed herpes zoster after surgery. Combining the patient's clinical manifestations and relevant laboratory tests, it was suggested that the varicella zoster virus reactivated during the latent period after abdominal surgery, causing herpes zoster. Subsequently, the herpes virus invaded the visceral nerve fibers, causing gastrointestinal dysfunction and loss of intestinal peristalsis, which eventually led to intestinal obstruction. The patient was successfully treated through conservative treatment and antiviral therapy and subsequently discharged from the hospital.
Pseudo-intestinal obstruction secondary to herpes zoster infection is difficult to distinguish from mechanical intestinal obstruction owing to various causes. In cases of inexplicable intestinal obstructions, considering the possibility of a viral infection is essential to minimize misdiagnosis and missed diagnoses.
肠梗阻在临床实践中很常见。然而,腹部手术后带状疱疹并发肠梗阻的情况极为罕见。在诊断和治疗过程中,临床医生认为识别其发生的主要原因对于确保有效治疗和避免误诊至关重要。
在此,我们介绍一名40岁女性肠梗阻患者的病例,该患者接受了腹腔镜阑尾切除术后出现带状疱疹。结合患者的临床表现和相关实验室检查,提示水痘-带状疱疹病毒在腹部手术后的潜伏期重新激活,引发带状疱疹。随后,疱疹病毒侵犯内脏神经纤维,导致胃肠功能障碍和肠蠕动丧失,最终导致肠梗阻。该患者通过保守治疗和抗病毒治疗成功治愈,随后出院。
带状疱疹感染继发的假性肠梗阻因多种原因难以与机械性肠梗阻相鉴别。在不明原因肠梗阻的病例中,考虑病毒感染的可能性对于减少误诊和漏诊至关重要。