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摄入浓盐酸后发生肠瘘:一例罕见病例报告

Intestinal fistula following concentrated hydrochloric acid ingestion: a rare case report.

作者信息

Zhu Xiaoxi, Chen Yunchao, Ou Zejin, Zhang Ruichang, Wang Zhi

机构信息

Department of Intensive Care Unit, Guangzhou Twelfth People's Hospital, Guangzhou, China.

Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China.

出版信息

Int J Emerg Med. 2025 Jun 12;18(1):102. doi: 10.1186/s12245-025-00896-2.

Abstract

BACKGROUND

Ingestion of corrosive agents is a well-known cause of extensive and severe gastrointestinal tract injury. Acids can result in significant acute complications throughout the gastrointestinal system.

CASE PRESENTATION

Herein, we present a case of total gastrointestinal necrosis after a patient ingested a large amount of concentrated hydrochloric acid. Of note, the patient developed an intestinal fistula six days following ingestion, requiring surgical intervention. This case underscores the potential for delayed gastrointestinal necrosis with high-volume and concentrated hydrochloric acid ingestion. Early CT evaluation and multi-organ protection are crucial for such patients. For patients with no signs of perforation, multidisciplinary physicians should comprehensively evaluate the necessity of surgical exploration. In such cases, comprehensive treatment strategies can significantly improve outcomes.

CONCLUSIONS

The purpose of this case report is to highlight the complexities and challenges in managing severe hydrochloric acid ingestion, to discuss the multidisciplinary approach required for such cases, and to contribute to the existing literature by providing detailed insights into the clinical presentation, treatment, and outcomes of a rare and severe instance of concentrated HCl ingestion.

摘要

背景

摄入腐蚀性物质是广泛而严重的胃肠道损伤的一个众所周知的原因。酸可导致整个胃肠道系统出现严重的急性并发症。

病例介绍

在此,我们报告一例患者大量摄入浓盐酸后发生全胃肠道坏死的病例。值得注意的是,患者在摄入后六天出现肠瘘,需要手术干预。该病例强调了大量摄入浓盐酸导致胃肠道坏死延迟发生的可能性。早期CT评估和多器官保护对此类患者至关重要。对于没有穿孔迹象的患者,多学科医生应全面评估手术探查的必要性。在这种情况下,综合治疗策略可显著改善预后。

结论

本病例报告的目的是突出管理严重盐酸摄入病例的复杂性和挑战,讨论此类病例所需的多学科方法,并通过提供对罕见且严重的浓盐酸摄入病例的临床表现、治疗和预后的详细见解,为现有文献做出贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a9a/12160384/db632f165907/12245_2025_896_Fig1_HTML.jpg

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Clin Toxicol (Phila). 2024 Dec;62(12):787-792. doi: 10.1080/15563650.2024.2429442. Epub 2024 Dec 24.
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Hydrochloric acid ingestion in adults: presentation and outcomes in a 10-year retrospective cohort study.
Br J Anaesth. 2024 Dec;133(6):1344-1346. doi: 10.1016/j.bja.2024.07.032. Epub 2024 Sep 19.
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Man Presenting After Hydrochloric Acid Ingestion.盐酸摄入后就诊的男性。
Clin Pract Cases Emerg Med. 2024 Feb;8(1):77-79. doi: 10.5811/cpcem.1436.

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