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| 題 名 | 一位65歲男性以反覆性腹痛症狀表現=A 65-year-old Man Presented with Recurrent Abdominal Pain Symptoms |
|---|---|
| 作 者 | 黃琬惠; 曾斐祺; | 書刊名 | 安泰醫護雜誌 |
| 卷 期 | 30:2 2024.12[民113.12] |
| 頁 次 | 頁33-43 |
| 分類號 | 415.501 |
| 關鍵詞 | 腹痛; 內視鏡逆行性膽胰管攝影; 十二指腸穿孔; Abdominal pain; Endoscopic retrograde cholangiopancreatography; Duodenal perforation; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 臨床上,內視鏡逆行性膽胰管攝影術後出現腹痛情形,常被診斷為是胰臟炎。本案例是一位65歲男性患者,內視鏡逆行性膽胰管攝影術後因腹痛被診斷為胰臟炎,因臨床表徵及治療過程未見改善,經身體理學檢查和腹部電腦斷層確診為內視鏡逆行性膽胰管攝影術後十二指腸穿孔,緊急施行十二指腸修補術、移除膽道支架及淸創手術。手術後,經由藥物治療其病情方獲得控制。針對此類以反覆性腹痛症狀表現患者,當藥物治療效果不佳、臨床表徵與腹部持續劇烈疼痛時,需立即衛教個案禁食及給予靜脈輸液治療且應考慮將內視鏡逆行性膽胰管攝影術後十二指腸穿孔列為鑑別診斷,以及早做出診斷與治療,以降低死亡風險。 |
| 英文摘要 | Abdominal pain following Endoscopic Retrograde Cholangiopancreatography (ERCP) is often diagnosed as pancreatitis. The present case is a 65-year-old male that developed abdominal pain after ERCP. The patient was diagnosed with post-ERCP pancreatitis and treated accordingly, but his abdominal pain did not improve. Abdominal computed tomography revealed duodenal perforation, which was likely a complication of ERCP. The patient received emergent surgical duodenorrhaphy, removal of biliary duct stent, and debridement. Following surgery and subsequent medical treatment, the patient's condition improved. When treating post-ERCP patients with persistent, severe abdominal pain that is refractory to conservative therapy, patients should be placed on nil per os status, provided intravenous hydration, and post-ERCP intestinal perforation must be considered to allow for early diagnosis, treatment, and mitigating morbidity and mortality. |
本系統中英文摘要資訊取自各篇刊載內容。