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Ascaris lumbricoidesによるイレアル穿孔: 腹膜炎によって合併されたイレオストミーにおける偶然の発見
Jesus Sebastian Luna Medrano1, Maylin Abigail Matienzo Rafael2, Carlos Rojas-Arana3
1Universidad Nacional José Faustino Sanchez Carrión, Av. Mercedes Indacochea 609, Huacho 15136, Peru.
Journal of surgical case reports
|September 4, 2025
まとめ
アスカリアーシスは,一般的な虫感染症で,生命を脅かす腸の穴をめったに起こさない. このケースは,特に流行地域において,穴開きを診断する際にアスカリアーシスを考慮する必要性を強調しています.
科学分野:
- * 感染症
- * 胃腸内科
- * 外科病理学
背景:
- アスカリス lumbricoidesによって引き起こされるアスカリアシスは,特に発展途上国において,世界中で最も一般的なヘルミンチス感染症です.
- * 腸内閉塞は一般的な合併症ですが,腸内炎に至る腸内穴はまれですが,重症です.
- * 非特異的な症状とエオシノフィリアの欠如は診断を遅らせます.
研究 の 目的:
- * アスカリアーシスによる腸の穿孔の珍しい症例を報告する.
- * アスカリアーシスを特有地域における腸穴の微分診断に考慮する重要性を強調する.
- * この状態の管理における早期の外科的介入と臨床的疑惑の重要な役割を強調する.
主な方法:
- * 長期にわたる腹部症状を呈した45歳の女性の症例報告
- * 腹腔切開手術で,大腸穴の穴に二次的に広がった腹腔炎が現れた.
- * イレア切除とイレオストミーによる外科治療,その後は集中的な術後のケア.
主要な成果:
- * 緊急の腹腔切開で大腸内炎が確認された.
- 呼吸不全やセプティックショックなど,重複手術が必要となった.
- 手術後33日,大きな"アスカリス・ルンブリコイドス"の虫がイレオストミーで排出され,病因が確認された.
結論:
- * アスカリアシスの腸穴は,ワーム負担による圧力誘発性不血症によって引き起こされる可能性が高い.
- * アスカリアシスは,特に感染が流行している地域では,腸穴の微分診断において重要な考慮事項であるべきです.
- * 迅速な外科的介入,高い臨床的疑念,効果的な予防戦略は,患者のアウトカムを改善するために不可欠です.
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