Toxic epidermal necrolysis after injection of sclerosing agent and medical adhesive into oesophageal variceal ligation in a patient with a malignant liver tumour: A case report.
Liangchao Hao, Wei Cai, Zhaomu Zeng, Xiuchao Geng, Qiang Li, Hong Chen, Yuhao Zhang, Juan Ding
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引用次数: 0
Abstract
Chronic liver disease can cause an increase in portal sinus pressure, which may lead to rupture and bleeding of esophageal and gastric varices. Oesophageal variceal ligation, with use of sclerosing agent and tissue glue injection is commonly used in clinical practice to address oesophageal bleeding. A 58-year-old male patient with chronic liver disease was treated with oesophageal variceal ligation, sclerosing agent and tissue glue injection due to oesophageal and gastric variceal bleeding. After 2 days, the skin of the patient exhibited erythema to different degrees. After 10 days of dexamethasone treatment, the whole-body rash worsened, and a severe skin reaction appeared that was suggestive of toxic epidermal necrolysis (TEN). Strict mucosal care was provided, and corticosteroids, γ globulin and adalimumab were concurrently used for treatment. After 20 days, the patient recovered from the skin problems. To the best of our knowledge, TEN after endoscopic surgery has rarely been reported in the relevant literature. Furthermore, when patients being treated with multiple drugs have erythema multiforme, physicians should be alert to the possibility of its development into TEN. The present case report summarizes the treatment methods for patients with TEN, providing a practical clinical basis and direction for the future diagnosis and treatment of the condition.
慢性肝病会导致门静脉窦压力升高,从而可能导致食管和胃静脉曲张破裂和出血。临床上常用食管静脉曲张结扎术,配合使用硬化剂和组织胶注射来解决食管出血问题。一名 58 岁的男性慢性肝病患者因食道和胃静脉曲张出血,接受了食道静脉曲张结扎、硬化剂和组织胶注射治疗。2 天后,患者皮肤出现不同程度的红斑。地塞米松治疗 10 天后,全身皮疹加重,出现严重的皮肤反应,提示为中毒性表皮坏死(TEN)。患者接受了严格的粘膜护理,并同时使用皮质类固醇、γ 球蛋白和阿达木单抗进行治疗。20 天后,患者的皮肤问题痊愈。据我们所知,内窥镜手术后出现 TEN 的情况在相关文献中鲜有报道。此外,当接受多种药物治疗的患者出现多形红斑时,医生应警惕其发展为 TEN 的可能性。本病例报告总结了 TEN 患者的治疗方法,为今后的诊断和治疗提供了实用的临床依据和方向。