Roger A. Sernaque Mechato, Stephanie T. Castillo Arias, Silvana RS. Ñaupari Jara, Flor M. Mendoza Barreto
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引用次数: 0
摘要
中毒性巨结肠是一种致命疾病,最常见于炎症性肠病、感染和肠缺血的并发症。其特征是出现血性腹泻、腹胀、全身中毒症状,并且在影像学检查中可观察到结肠节段性扩张。根据 Jalan 的诊断标准:结肠扩张超过 6 厘米,具备以下三项:发热、心动过速、白细胞增多或贫血,以及以下任何一项:低血压、低血容量、电解质紊乱和精神状态改变。本文介绍了一名女性患者的病例,她因腹痛和慢性腹泻入院,影像学检查显示整个结肠框架扩张。溃疡性结肠炎引起的中毒性巨结肠,接受药物治疗后病情好转,出院后因脓毒性休克再次入院,进行检查后确定为艰难梭菌感染,开始使用抗生素治疗,但病情发展不利,导致患者死亡。本病例表明这种疾病的死亡率很高。
Toxic megacolon is a fatal disease, most commonly occurring as a complication of inflammatory bowel disease, infections, and intestinal ischemia. It is characterized by the presence of bloody diarrhea, abdominal distension, signs of systemic toxicity, and segmental colonic dilation is observed in imaging studies. The diagnosis according to Jalan's criteria are: colonic dilation more than 6cm, three of the following: fever, tachycardia, leukocytosis or anemia, and any of the following criteria: hypotension, hypovolemia, electrolyte disorder and altered mental status. This article presents the case of a female patient who was admitted with abdominal pain and chronic diarrhea with an imaging study showing dilation of the entire colonic framework. The corresponding studies were carried out which indicated that she had a toxic megacolon due to colitis. ulcerative, receives medical treatment with favorable evolution, is discharged and readmitted for septic shock, studies are performed and Clostridium difficile infection is identified, antibiotic treatment is started but the evolution is unfavorable, which caused the death of the patient. The present case represents the high mortality of this disease.