松散的PEG管导致周围膜泄漏和周围炎,一个案例报告
1University of California, Irvine, Department of Emergency Medicine, Orange, CA.
Journal of education & teaching in emergency medicine
|July 19, 2023
概括
一名患有肌缩侧面硬化症 (ALS) 和新的皮肤内镜胃口管 (PEG) 的患者出现了腹部症状. 胸部X射线显示,腹上有空气,这表明可能有胃肠道穿孔或泄漏.
科学领域:
- 胃肠病学 胃肠病学
- 放射学 放射学是一门学科.
- 手术并发症 手术并发症
背景情况:
- 肌缩侧面硬化症 (ALS) 通常需要输入管,通常是通过皮肤内镜胃口术 (PEG).
- 虽然PEG手术的并发症率很低,但潜在的风险包括胃肠道穿孔和周围肠道泄漏.
- 腹部症状如疼痛,恶心,吐和膨胀可能表明严重的并发症.
研究的目的:
- 突出胸部X射线在评估PEG管安置后潜在的胃肠道并发症的诊断效用.
- 强调在出现急性腹部症状的患者中考虑PEG相关并发症的重要性.
主要方法:
- 一个37岁的男性患有ALS的病例报告,最近的PEG安置呈现出急性腹部症状.
- 使用的诊断成像:直立/腰胸部X射线.使用诊断成像:直立/腰胸部X射线.
- 临床评估包括对腹膜炎的评估.
主要成果:
- 胸部X射线显示了双边自由腹空气.
- 结果表明,在PEG管放置后,可能出现胃肠道穿孔或周围肠道泄漏.
- 患者呈现出腹膜炎的经典症状:腹痛,恶心,吐,膨胀,疼痛和警.
结论:
- 胸部X射线是一种高效和准确的工具,用于诊断空腹腔空气,表明胃肠道穿孔,特别是在紧急情况下.
- 临床医生应在有相关病史和急性腹部症状的患者中保持对PEG相关并发症的高度怀疑指数.
- 及时识别和评估潜在的PEG并发症对于及时管理和改善患者结果至关重要.
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