Ando Y, Kikuchi K, Ichikawa N, Meigata K, Nomura Y, Watanabe K, Beck Y, Degawa H, Tomikawa S, Nagao T, Uchida H
Department of Surgery and Transplantation, University of Tokyo, Japan.
Surg Today. 1997;27(4):353-6. doi: 10.1007/BF00941812.
We herein report the case of a 53-year-old man with a nonspecific acute colonic ulcer whose liver function deteriorated after he had undergone hepatectomy. He was referred to our hospital for a hepatoma caused by hepatitis B virus and a right hemihepatectomy was performed. His liver function was poor after the operation, and minor complications such as pleural effusion and biliary fistula developed. A large amount of melena was seen 29 days after the hepatectomy and he developed hemorrhagic shock. Superior mesenteric arteriography revealed pooling of blood in both the hepatic flexure of the ascending colon and the cecum. An emergency right hemicolectomy was performed. There was a 5 x 1-mm ulcer 18 cm distal to the ileocecal valve. Numerous erosions were observed to be scattered throughout the colonic mucosa. The patient recovered slowly and was discharged 6 months after the hepatectomy. This is the first report of an acute colonic ulcer that could have been caused by liver dysfunction.
我们在此报告一例53岁男性患者,患有非特异性急性结肠溃疡,其在接受肝切除术后肝功能恶化。他因乙型肝炎病毒引起的肝癌被转诊至我院,并接受了右半肝切除术。术后他的肝功能较差,出现了胸腔积液和胆瘘等轻微并发症。肝切除术后29天出现大量黑便,并发展为失血性休克。肠系膜上动脉造影显示升结肠肝曲和盲肠均有血液淤积。遂进行了急诊右半结肠切除术。在回盲瓣远端18 cm处有一个5×1 mm的溃疡。观察到整个结肠黏膜有多处糜烂。患者恢复缓慢,肝切除术后6个月出院。这是首例可能由肝功能障碍引起的急性结肠溃疡的报告。