NEJM:可逆性急性肠系膜缺血-案例报道

2016-10-13 MedSci MedSci原创

一位60岁的男子出现腹痛和低血压。

患者男性,60岁,出现腹痛和低血压。


近日检查发现,该患者有肠系膜上动脉血栓形成,需要广泛切除远端空肠和回肠。

实验室检查显示,其血清乳酸水平为2.6mmol/L,和肌酐水平为1.6mg/dL。

CT扫描结果显示空肠扩张,肠壁变薄(如图A,箭头处),提示残余空肠存在急性肠系膜缺血的危险因素。

空肠内镜检查发现黏膜坏死和出血现象(如图B,请点击原始链接观看视频1)。

由于广泛的远端血栓形成,因此动脉血运重新并不是最佳的治疗方案,最后病人接受肠外营养、静脉输液,应用肝素和阿司匹林抗凝,同时口服抗生素抗感染治疗。

经治疗14天,该患者的症状明显减轻,再次行内镜检查发现其肠道黏膜愈合(如图C,请点击原始链接观看视频2)。

患者出院后,口服进食,无复发的迹象表现。

原始出处:

Alexandre Nuzzo, M.D., and Olivier Corcos, M.D.Reversible Acute Mesenteric Ischemia. N Engl J Med 2016; 375:e31.October 13, 2016.DOI: 10.1056/NEJMicm1509318

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    2016-10-14 zzc2216
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