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短肠综合征的挑战性管理

The Challenging Management of Short Bowel Syndrome.

作者信息

Kountouri Ismini, Faseki Afroditi, Panagiotou Alexandra, Sevva Christina, Katsarelas Ioannis, Chatzinas Dimitrios, Papadopoulos Konstantinos, Stergios Vasilis, Mantalovas Stylianos, Karakousis Vasileios Alexandros, Nachopoulos Panagiotis, Polychronidis Athanasios, Husamieh Mohammad, Gkogkos Christos, Dagher Marios, Roulia Panagiota, Giotas Amyntas, Chandolias Miltiadis, Dimasis Periklis, Manolakaki Dimitra, Kesisoglou Isaak, Gkiatas Nikolaos

机构信息

Third Surgical Department, AHEPA University Hospital, Medical Faculty, Aristotle University of Thessaloniki, 1 Kiriakidi Street, 54636 Thessaloniki, Greece.

Department of General Surgery, General Hospital of Katerini, 60132 Pieria, Greece.

出版信息

Diagnostics (Basel). 2025 Jun 16;15(12):1532. doi: 10.3390/diagnostics15121532.

Abstract

A 62-year-old female presented to the Emergency Department of the General Hospital of Katerini, Greece, complaining of abdominal pain, fever, and general discomfort. Laboratory tests indicated an elevated white blood cell count and an elevated C-reactive protein level. A computed tomography (CT) scan revealed dilated small bowel loops and free intraperitoneal fluid. During laparotomy, extensive ischemia and necrosis of both the small and large bowel were discovered, and a resection of the small bowel and the right colon was performed, leaving the patient with only 90 cm of small intestine and a jejunocolic anastomosis. Postoperative management was particularly challenging, requiring a multidisciplinary approach, an intensive care unit stay, reoperations due to anastomotic leaks, continuous parenteral nutrition and electrolyte management, and aggressive antibiotic treatment for persistent bacterial infections. This case report highlights the importance of appropriate management of this life-threatening complication following extensive bowel resection.

摘要

一名62岁女性前往希腊卡特里尼综合医院急诊科就诊,主诉腹痛、发热和全身不适。实验室检查显示白细胞计数升高和C反应蛋白水平升高。计算机断层扫描(CT)显示小肠袢扩张和腹腔内游离液体。剖腹手术中发现小肠和大肠均有广泛缺血坏死,遂行小肠和右半结肠切除术,术后患者仅余90厘米小肠并进行了空肠结肠吻合术。术后管理极具挑战性,需要多学科方法、入住重症监护病房、因吻合口漏进行再次手术、持续肠外营养和电解质管理,以及针对持续性细菌感染的积极抗生素治疗。本病例报告强调了广泛肠切除术后对这种危及生命并发症进行适当管理的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e1b/12191585/e853c44558db/diagnostics-15-01532-g001.jpg

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