A
71-year-old female patient was admitted to emergency department with a general
condition disorder and fever. She had a history of stroke, hypertension and
diabetes, and had a history of operation for colon carcinoma 2.5 years ago. On
examination, his consciousness was stupor. Intra-venous contrast-enhanced
computed abdominal tomography showed diffuse distension consistent with ileus
in small bowel segments. Intramural gas images were seen in the distal ileal
segments. Gas images compatible with portal system were present in the liver.
Emergency laparotomy was performed. It was observed that the 40 cm small bowel
loops adhered to the posterior abdominal wall of the pelvis and necrosis of
this segment was observed during the operation.
The
association of pneumocystis intestinalis with porto-mesenteric venous gas is
indicative of intestinal necrosis. Emergency surgical treatment should be
performed as in our case.
71
yaşında bir kadın hasta acil servise genel durum bozukluğu ve ateş şikâyeti ile
başvurdu. Hastanın özgeçmişinde 2,5 yıl önce kolon kanseri için ameliyat öyküsü
vardı. Muayenesinde bilinci stupor olarak değerlendirildi. İntravenöz
kontrastlı bilgisayarlı abdominal tomografide ince bağırsak segmentlerinde
ileus ile uyumlu yaygın distansiyon mevcuttu. Distal ileal segmentlerde
intramural gaz görüntüleri izlendi. Karaciğerde portal sistemle gaz imajı
izlendi. Hastaya acil laparotomi planlandı. Operasyon sırasında ileal 40 cm
segmentin karın arka duvarına yapışık olduğu ve bu segmentin nekroze olduğu
gözlendi.
Pnömosistis
intestinalis ile porto-mezenterik venöz gaz arasındaki ilişki intestinal
nekrozun göstergesidir. Acil cerrahi tedavi olgumuzda olduğu gibi yapılmalıdır.
Primary Language | English |
---|---|
Subjects | Clinical Sciences |
Journal Section | Case Report |
Authors | |
Publication Date | February 29, 2020 |
Submission Date | November 17, 2019 |
Acceptance Date | February 2, 2020 |
Published in Issue | Year 2020 Volume: 2 Issue: 1 |
Hitit Medical Journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY NC).