二次性艾滋病毒胆管病变是急性胆管炎的原因:一个病例报告
Guillermo Avalos Gonzalez1, Mariana Carolina Gasga Velasco1, Paola V Rosales Verduzco1
1Internal Medicine, Hospital Regional Dr. Valentín Gómez Farías - Institute for Social Security and Services for State Workers or Civil Service Social Security and Services Institute (ISSSTE), Zapopan, MEX.
Cureus
|August 28, 2025
概括
艾滋病毒相关胆血管病变 (HAC) 是晚期艾滋病毒的一种罕见并发症. 早期内镜干预对于治疗胆道阻塞和改善受影响患者的治疗结果至关重要.
科学领域:
- 肝病学
- 传染性疾病
- 胃肠病学
背景情况:
- 艾滋病毒相关胆管病变 (HAC) 是晚期免疫抑制 (CD4+ < 100细胞/μL) 患者的严重肝胆道并发症.
- 它通常是由机会性感染引起的,导致胆固醇和胆道阻塞.
研究的目的:
- 在HIV感染患者中呈现HAC病例,CD4计数无法检测,病毒载量增加.
- 突出诊断和管理的挑战.
主要方法:
- 一名58岁的艾滋病毒感染者患有黄和腹部疼痛.
- 诊断工作包括确定偏远的普通胆道狭窄.
- 治疗包括内逆流胆细胞造影 (ERCP) 和胆管支架的安置.
主要成果:
- 患者出现了黄,严重疼痛,恶心,吐和体重减轻.
- 鉴定出一种复杂的远端普通胆道狭窄,导致急性胆道炎,阻塞性胰腺炎和急性损伤.
- 胆管支架的ERCP导致显著的临床改善.
结论:
- 在具有胆固醇性肝脏特征的免疫抑制患者中,应考虑使用HAC.
- 及时的内镜干预和多学科管理对于HAC的良好结果至关重要.
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