腹部子宫切除术后并发症：肠皮肤瘘导致的低钾性肾病——病例报告
Post-abdominal hysterectomy complications: hypokalemic nephropathy due to enterocutaneous fistula - a case report.
作者信息
Hamza Hafiz Muhammad, Ahsan Areeba, Khan Naveed Ullah, Awan Ayaz Ahmed, Rai Deepak, Tariq Muhammad Daoud
机构信息
Department of General Surgery, Foundation University Medical College, Islamabad, Pakistan.
Department of Internal Medicine, Foundation University Medical College, Islamabad, Pakistan.
出版信息
Ann Med Surg (Lond). 2025 Jun 18;87(8):5268-5272. doi: 10.1097/MS9.0000000000003512. eCollection 2025 Aug.
INTRODUCTION AND IMPORTANCE
Hypokalemic nephropathy is a rare but serious complication of enterocutaneous fistulas (ECFs), particularly following abdominal surgery. This case highlights the importance of recognizing and managing electrolyte imbalances to prevent renal dysfunction.
CASE PRESENTATION
A 57-year-old woman developed an ECF 6 days after undergoing total abdominal hysterectomy for uterine fibroids. She presented with severe hypokalemia (serum potassium 2.7 mmol/L) and polyuria, leading to hypokalemic nephropathy. The patient was treated with aggressive potassium supplementation and an ileo-colostomy. Over 10 days, her potassium levels normalized, and renal function improved.
CLINICAL DISCUSSION
This case illustrates the risk of renal dysfunction due to hypokalemia in patients with ECFs. Early recognition and prompt management are crucial to avoid life-threatening complications.
CONCLUSION
A multidisciplinary approach and timely intervention in ECFs are vital to prevent complications like hypokalemic nephropathy and ensure renal recovery.
引言与重要性
低钾性肾病是肠皮肤瘘（ECF）一种罕见但严重的并发症，尤其是在腹部手术后。本病例强调了识别和处理电解质失衡以预防肾功能障碍的重要性。
病例介绍
一名57岁女性因子宫肌瘤接受全腹子宫切除术后6天出现肠皮肤瘘。她表现为严重低钾血症（血清钾2.7 mmol/L）和多尿，导致低钾性肾病。患者接受了积极的补钾治疗和回肠结肠造口术。10多天后，她的钾水平恢复正常，肾功能得到改善。
临床讨论
本病例说明了肠皮肤瘘患者因低钾血症导致肾功能障碍的风险。早期识别和及时处理对于避免危及生命的并发症至关重要。
结论
多学科方法以及对肠皮肤瘘的及时干预对于预防低钾性肾病等并发症并确保肾功能恢复至关重要。
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