- 期刊
Ischaemic Necrosis of Small and Large Intestine in a 35-year-old Female with 45% Deep Second-degree Burns-A Case Report
缺血性腸壞死在一全身45％灼傷病人之病例報告
摘要
背景：缺血性腸壞死是腹部急症之一，有效的治療在於及時的診斷、早期的手術及最佳的支持性療法。目的及目標：對大面積灼傷的病患做出缺血性腸壞死的診斷是一臨床上困難的挑戰，臨床上高度的警覺及電腦斷層檢查可協助醫師早期診斷。材料及方法：我們提出一35歲合併吸入性灼傷及全身45%體表面積深二度灼傷的女性病患。病患於灼傷後第3天首次接受灼傷傷口清創手術。灼傷後第10天患者被診斷出缺血性腸壞死，並接受緊急開腹探查及壞死腸道切除手術。結果：儘管多次傷口清創及開腹腸道手術，患者於灼傷後32天死於嚴重敗血症及多重器官衰竭。結論：對大面積灼傷的病患而言，缺血性腸壞死為一罕見而嚴重的併發症。高度的臨床警覺性、及早電腦斷層檢查與手術介入治療，是挽救病患生命的唯一方式。
關鍵字
無資料並列摘要
Background:Ischemic bowel disease (IBD) is a true abdominal emergency. Effective treatment of IBD relies on timely diagnosis, early surgical intervention and optimal supportive care.Aim and Objectives:IBD poses a greater diagnosis challenge in major burn patients. Clinical suspicion and computed tomography (CT) examination will help early diagnosis.Materials and Methods:We reported a 35-year-old female patient, who presented with deep second-degree burn involving 45% total body surface area and inhalation injury. Burn wound debridement started at post-traumatic day 3 (PTD 3). Ischemic bowel disease was diagnosed on PTD 10 and emergent laparotomy with necrotic bowel resection was performed.Results:Despite of repeated burn wound debridement and laparotomy for ischemic bowel disease. She died of severe sepsis and multiple organ failure on PTD 32.Conclusion:For major burn patients, ischemic bowel disease was a rare but devastating complication. High index of clinical suspicion, timely CT study and early surgical intervention is the only way to save the patient.