查詢結果分析
來源資料
頁籤選單縮合
題 名 | 志賀桿菌痢疾造成之毒性結腸擴張--病例報告=Toxic Megacolon in Shigellosis--A Case Report |
---|---|
作 者 | 白明忠; 許自齊; 熊立榕; 施壽全; 高進祿; | 書刊名 | 內科學誌 |
卷 期 | 8:4 1997.12[民86.12] |
頁 次 | 頁199-202 |
分類號 | 416.245 |
關鍵詞 | 毒性結腸擴張; 志賀桿菌性痢疾; 感染性腸炎; Toxic megacolon; Shigellosis; Infective colitis; |
語 文 | 中文(Chinese) |
中文摘要 | 毒性結腸擴張是潰瘍性結腸炎和克隆氏病常見的併發症。然而,它是志賀桿菌痢 疾少見的併發症。如果盡早發現是由於感染性腸炎引起的毒性結腸擴張,可以用內科治療。 當給予內科治療而情況變壞時,外科手術切勿延遲。一位四十八歲女性病人患有多糖尿病和 精神分裂症病史。臨床發現有數天的發燒、畏冷、瀰慢性腹痛和黃色血絲的腹瀉,理學檢查 發現腹部腫脹及壓痛。乙狀結腸鏡顯示有直腸炎。實驗數據發現;白血球分偏左,高血糖, 低血鉀和低白蛋白血症。腹部X光表現大腸擴張,尤其是橫結腸部位,臨床表現出大腸瀕 臨破裂的可能性,於是進行外科剖腹術,同時給予輸液和抗生素治療。剖腹發現橫結腸擴張, 腸壁水腫變厚。由於診斷尚未確定,所以實施盲腸造口術使結腸擴張減壓。住院時大便培養 報告為志賀氏副痢疾桿菌。於是診斷為志賀桿菌痢疾造成之毒性結腸擴張,經繼續以臥床休 息、輸液、鼻胃管減壓術和抗生素治療。病人術後順利的康復。 Q的康復。 |
英文摘要 | This is a report of a case of toxic megacolon associated with shigellosis. A 48-year-old female suffering from diabetes mellitus and schizophrenia for several years presented with fever, chilliness, diffuse abdominal pain and yellowish blood-tinged diarthea for 7-8 days. There was moderate distension of her abdomen, which was generally tender. Sigmoidoscopy suggested most likely infective proctitis. There was normal white blood cell count with a shift to the left(band 16, seg 33), hyperglycemia, hypokalemia and hypoalbuminemia. Serial plain abdominal X-ray showed marked distension of the large bowel, especially the transverse colon. In view of the patient's failure to improve with antibiotics and the possibility of imminent large bowel perforation, a laparotomy was performed after rehydration. At laparotomy, the transverse colon was markedly distended. The wall was thickened and edematous. An appendical cecostomy was performed to decompress the colonic dilatation since the findings were not completely consistent with inflammatory bowel disease. The stool culture taken on the day of admission was reported to contain Shigella flexneri. A diagnosis of toxic megacolon complicating shigellosis was made and the patient was treated wth bed rest, rehydration, nasogastric draiinage and antibiotics. The patient eventually recovered completely. |
本系統中英文摘要資訊取自各篇刊載內容。