一个男性患者的菲茨 - 休 - 库蒂斯综合征
Ahmed Mostafa1, Mohamad Alhalabieh1, Justin Scarano1
1General Surgery, Nazareth Hospital - Trinity Health Mid-Atlantic, Philadelphia, USA.
Cureus
|June 21, 2024
概括
菲茨 - 休 - 柯蒂斯综合征 (FHCS) 可以导致男性难以治愈的右上象限疼痛,即使有负面的炼. 早期诊断和治疗FHCS可以防止广泛的测试和改善患者的结果.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 外科手术病例报告
背景情况:
- 耐火性右上象限 (RUQ) 腹痛往往需要广泛的诊断工作.
- 阴性胆道和上胃肠道成像和内镜评估可以使诊断复杂化.
- 菲茨-休-柯蒂斯综合征 (FHCS) 通常与骨盆炎症相关,主要发生在女性身上.
研究的目的:
- 报告一个FHCS病例呈现为男性患者难以治疗的RUQ疼痛.
- 强调在男性无法解释的RUQ疼痛的差异诊断中考虑FHCS的重要性.
- 要突出诊断挑战和成功治疗FHCS在这个患者群体.
主要方法:
- 一名38岁的男性有7年的难治性RUQ病史和上胃疼痛,因疑似胆道动力障碍而接受机器人胆囊切除术.
- 在手术期间的发现显示了广泛的双边周肝粘附,暗示FHCS.
- 进行了粘附溶解和形肝活检;组织学证实慢性胆囊炎和周肝纤维化.
主要成果:
- 针对FHCS的手术干预导致了患者慢性RUQ和腹上疼痛的完全消失.
- 组织学检查揭示了周肝间皮纤维化和轻度肝硬化,没有肝纤维化.
- 患者在手术后两周经历了显著的症状改善.
结论:
- 在男性患者的差异诊断中应考虑FHCS,即使在最初的负面调查中,也应考虑耐火RUQ腹痛的男性患者.
- 迅速识别和手术治疗FHCS可以缓解慢性疼痛,避免长期的,不必要的诊断程序.
- 这一案例强调了FHCS的非典型表现及其在男性患者中成功管理的情况.
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