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相關文獻
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題名 | Thoracic Empyema Associated with Colorectal Cancer--A Case Report and Literature Review=大腸直腸癌合併膿胸--病例報告及文獻回顧 |
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作者 | 劉景隆; 李昭賢; 吳健樑; 陳培然; | 書刊名 | 胸腔醫學 |
卷期 | 19:4 2004.08[民93.08] |
頁次 | 頁273-278 |
分類號 | 416.245 |
關鍵詞 | 膿胸; 大腸直腸癌; 鬆脆類桿菌; Thoracic empyema; Colorectal cancer; Bacteroides fragilis; |
語文 | 英文(English) |
中文摘要 | 一位31歲先前健康的女性病患,此次因腹膿瘍經腹腔引流術後轉診入院接受治療。住院期間,發現左側膿胸,而肋膜積液細菌培養結果為鬆脆類桿菌(Bacteroides fragilis)感染。之後,病患確診為直腸腺癌合併腸破裂,因而造成腹膿瘍。另一個意外的病理發現,在一條小靜脈管徑內存在著散播性的微小膿瘍。 據我們所知,自1960年代以來,共有六例大腸直腸癌合併膿胸罕見病例之文獻記載。其中,除二例發現有大腸肋膜?管外,其餘四例的感染途徑並不十分清楚。在本篇報告中的一個意外發現,在一條小靜脈管徑內存在散播性的微小膿瘍,由此可以證明鬆脆類桿菌,一種大腸直直正常內生菌,可以進入血液循環,造成菌血症和膿胸。因此,在一個不尋常的內生腸道菌感染,有可能存在著惡性腫瘤。 |
英文摘要 | A previously healthy 31-year-old female was transferred to our hospital after laparoscopic drainage of an abdominal abscess. She was found to have a left-sided empyema, which grew Bacteroides fragilis on culture. She was then diagnosed with rectal adenocarcinoma that had perforated, accounting for the abdominal abscess. An unusual pathologic finding in the resected specimen was septic thrombi in the lumen of a small vein. To our knowledge, only six other cases of empyema associated with colorectal cancer have been reported since the 1960s. Aside from the colo-pleural fistula in two of those cases, the route of pleural infection in the reported cases was not totally clear. The finding of septic thrombi in a small vein in our case is good evidence that B. fragilis, a normal flora in the colorectum, may enter the circulation causing bacteremia and empyema. Therefore, unusual infections with fecal flora may indicate the presence of a malignancy. |
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