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成功治疗伴有胃肠道出血的严重登革热:一例突出内镜止血的病例报告

Successful Management of Severe Dengue With Gastrointestinal Bleeding: A Case Report Highlighting Endoscopic Hemostasis.

作者信息

Nouh Abdelrahman K, Haj Mohamad Hamza, Toubah Abduljaleel M, Jaber Abdallah A, Alkaram Sana S, Shaheen Mahasin, Hashmi Ubaid Ur Rehman

机构信息

Internal Medicine, Al Qassimi Hospital, Sharjah, ARE.

出版信息

Cureus. 2024 Nov 21;16(11):e74142. doi: 10.7759/cureus.74142. eCollection 2024 Nov.

Abstract

Dengue fever, caused by the dengue virus and transmitted by mosquitoes, poses a significant global health threat, particularly in tropical and subtropical regions. Severe cases can manifest as dengue hemorrhagic fever (DHF) or dengue shock syndrome, leading to complications such as plasma leakage, fluid accumulation, respiratory distress, severe bleeding, and organ impairment. Among these complications, gastrointestinal (GI) bleeding is particularly concerning due to its potential to rapidly deteriorate the patient's condition. While endoscopic hemostasis is an effective intervention for controlling GI bleeding, its application in severe dengue cases is underreported. We present the case of a male in his late 30s with severe dengue complicated by GI bleeding. Despite resuscitative measures and blood component transfusions, his condition deteriorated, necessitating endoscopic intervention for hemostasis. Successful endoscopic therapy with clips and adrenaline achieved hemostasis, highlighting the efficacy of this approach in managing severe dengue-associated GI bleeding. Primary dengue virus infection typically presents as dengue fever, while a minority progresses to develop DHF, characterized by plasma leakage and severe bleeding. Prompt recognition and management are crucial in mitigating DHF-associated morbidity and mortality. Endoscopic intervention plays a vital role in localizing and controlling bleeding sources, as demonstrated in our case. Further research is warranted to elucidate optimal treatment strategies and long-term outcomes in this patient population.

摘要

登革热由登革病毒引起,通过蚊子传播,对全球健康构成重大威胁,在热带和亚热带地区尤为严重。严重病例可表现为登革出血热(DHF)或登革休克综合征,导致血浆渗漏、液体潴留、呼吸窘迫、严重出血和器官损害等并发症。在这些并发症中,胃肠道(GI)出血因其可能迅速恶化患者病情而尤为令人担忧。虽然内镜止血是控制胃肠道出血的有效干预措施,但其在严重登革热病例中的应用报道较少。我们报告了一例30多岁晚期男性严重登革热并发胃肠道出血的病例。尽管采取了复苏措施和成分输血,但其病情仍恶化,需要进行内镜止血干预。使用夹子和肾上腺素进行的内镜治疗成功实现了止血,突出了这种方法在处理严重登革热相关胃肠道出血方面的有效性。原发性登革病毒感染通常表现为登革热,少数会发展为登革出血热,其特征为血浆渗漏和严重出血。及时识别和处理对于降低登革出血热相关的发病率和死亡率至关重要。如我们的病例所示,内镜干预在定位和控制出血源方面起着至关重要的作用。有必要进一步研究以阐明该患者群体的最佳治疗策略和长期预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b015/11663031/fe2585d00fed/cureus-0016-00000074142-i01.jpg

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