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題名 | Pleural Empyema Following a Silent Cholecystoduodenocolic Fistula--A Case Report=膽囊十二指腸結腸廔管合併膿胸--病例報告 |
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作者 | 許永隆; 廖永祥; 姜文智; | 書刊名 | 胸腔醫學 |
卷期 | 16:4 2001.12[民90.12] |
頁次 | 頁264-270 |
分類號 | 416.245、416.245 |
關鍵詞 | 膿胸; 膽囊十二指腸結腸廔管; Pleural empyema; Cholecystoduodenocolic fistula; |
語文 | 英文(English) |
中文摘要 | 膽囊十二腸結腸廔管併膿胸在臨床上是一種少見的肺部併發症。我們描述一位66歲男性,因膽囊及總膽管結石合併感染,造成膽囊十二腸結腸廔管、膽道充氣顯影及發燒、右側助膜積液入院。右側助膜積液抽吸檢查發現為滲出液,其助膜積液與血清之總膽紅素比值偏高培養長出E. coli, Bacteroides及 Condida albicans混合感染。內視鏡逆流膽道攝影證實為膽囊十二指腸結腸廔管。我們探討其右側膿胸的原因,認為可能是腸道溢出之病原菌,經由橫膈膜的缺口進入助膜腔後再併發感染。我們回顧過的文獻報告並探討其原因與處理方式。 |
英文摘要 | A cholecystoduodenocolic fistual associated with pleural empyema is a rare pulmonary complication. We report a case of a 66-year-old man with fever, right pleural effusion revealed an exudate with a high pleural effusiona/serum total billirubin ratio and E. coli, Bacteroides and Candida albicans in culture. The endoscopic retrograde cholangiogram showed a cholecystoduodenocolic fistula. The righ pleural empyema could have been caused by a leakage of pathogens from the gastrointestinal tract through the diaphragm into the pleural cavity. Proper antibiotics treatment with drainage with drainage and repair of the digestive organ defects would be mandatory for such a patient. |
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