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并发肝功能不全和酒精使用障碍患者复发性小肠梗阻的管理挑战:多学科方法

Challenges in Managing Recurrent Small Bowel Obstruction in a Patient With Concurrent Hepatic Dysfunction and Alcohol Use Disorder: A Multidisciplinary Approach.

作者信息

Sevgi Kaan, Enman Logan, Lucero Francisco, Aran Sinan Nazif

机构信息

School of Medicine, Kansas City University of Medicine and Biosciences, Kansas City, USA.

Department of Internal Medicine, University of Miami/HCA Florida, Coral Gables, USA.

出版信息

Cureus. 2025 May 31;17(5):e85139. doi: 10.7759/cureus.85139. eCollection 2025 May.

Abstract

This case report describes a 63-year-old Black man with recurrent small bowel obstruction (SBO), persistent abdominal pain, and hepatic dysfunction, set against a complex background of idiopathic peripheral neuropathy, chronic hepatomegaly, an indeterminate adrenal mass, and long-term alcohol use. Imaging revealed dilated bowel loops with partial obstruction, while laboratory findings showed elevated liver enzymes indicative of hepatic impairment. His clinical course highlighted the multifactorial nature of SBO, likely influenced by anatomical disruptions, hepatic pathology, and systemic metabolic factors, including potential adrenal involvement. The case emphasizes the importance of a multidisciplinary approach integrating gastroenterology, hepatology, and endocrinology to manage such intricate presentations. It also underscores the role of chronic alcohol use in exacerbating gastrointestinal and hepatic conditions, advocating for a holistic treatment strategy to optimize outcomes.

摘要

本病例报告描述了一名63岁的黑人男性,患有复发性小肠梗阻(SBO)、持续性腹痛和肝功能障碍,其背景复杂,包括特发性周围神经病变、慢性肝肿大、肾上腺肿块性质不明以及长期饮酒。影像学检查显示肠袢扩张伴部分梗阻,而实验室检查结果显示肝酶升高,提示肝功能损害。他的临床病程突出了SBO的多因素性质,可能受到解剖结构破坏、肝脏病变和全身代谢因素(包括潜在的肾上腺受累)的影响。该病例强调了采用多学科方法(整合胃肠病学、肝病学和内分泌学)来管理此类复杂病情的重要性。它还强调了长期饮酒在加重胃肠道和肝脏疾病方面的作用,提倡采用整体治疗策略以优化治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b0e/12208811/d8803de80c9e/cureus-0017-00000085139-i01.jpg

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