隔膜接手术后66岁男子患上奥吉尔维综合征:一种罕见的术后并发症
Hasan M Alswiket1, Hatem Y Elbawab2, Ali S Alrashed3
1College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
The American journal of case reports
|August 28, 2023
概括
本病例报告详细介绍了一个罕见的奥吉尔维综合征病例,这是一个功能性肠道阻塞,发生在腹膜复合手术后. 术前结肠膨胀可能是这种严重并发症的一个新发现的风险因素.
科学领域:
- 胃肠病学 胃肠病学
- 手术并发症 手术并发症
- 结肠直肠手术 结肠直肠手术
背景情况:
- 机械和功能性肠道阻塞是术后的重大并发症.
- 急性结肠伪阻塞 (Ogilvie综合征) 是一种功能性大肠阻塞,呈现为没有机械阻塞的腹部张张.
- 原因包括电解质失衡,药物,创伤,甲状腺功能低下症和各种手术.
研究的目的:
- 报告一个罕见的奥吉尔维综合征病例,该病例发生在隔膜复合手术后.
- 突出诊断挑战和术后结肠阻塞的潜在新风险因素.
- 强调迅速诊断和管理奥吉尔维综合征的重要性.
主要方法:
- 一个66岁的男性患者的病例报告,他接受了腹膜折叠手术.
- 术后评估包括临床评估,实验室测试 (白细胞病,ESR,CRP) 和腹部CT扫描.
- 干预涉及紧急探索性腹腔镜与结肠减压,随后是西格米多斯科比和医疗管理.
主要成果:
- 该患者在腹膜折叠手术后一天出现了奥吉尔维综合征,呈现出血动力学不稳定性和大规模的结肠膨胀.
- 脑电图扫描显示脏曲插入隔膜,但在腹腔镜或心体镜检查时没有发现机械阻塞.
- 医疗治疗最终有效地解决了患者的病情.
结论:
- 在这种情况下,诊断奥吉尔维综合征是具有挑战性的,因为它在隔膜折叠后的异常呈现.
- 术前结肠扩张可能是术后结肠阻塞的新风险因素.
- 术后奥吉尔维综合征的早期识别和治疗对于预防诸如大肠穿孔等并发症至关重要.
相关概念视频
01:28Esophageal Perforation-II: Clinical Manifestations and Management
88
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
88
01:26Esophageal Strictures-II: Clinical Features and Management
103
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
103
01:22Esophageal Perforation-I: Introduction
122
Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
122
01:21Inflammatory Bowel Disease V: Surgical Management
167
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
167
01:23Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
01:28Esophageal Varices-II: Clinical Features and Management
94
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
94