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Spontaneous gallbladder perforation and colon fistula in hypertriglyceridemia-related severe acute pancreatitis:A case report 被引量:1
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作者 Qi-Pu Wang Yi-Jun Chen +5 位作者 Mei-Xing Sun jia-yuan dai Jian Cao Qiang Xu Guan-Nan Zhang Sheng-Yu Zhang 《World Journal of Clinical Cases》 SCIE 2022年第17期5846-5853,共8页
BACKGROUND Gallbladder perforation and gastrointestinal fistula are rare but serious complications of severe acute pancreatitis(SAP).However,neither spontaneous gallbladder perforation nor cholecysto-colonic fistula h... BACKGROUND Gallbladder perforation and gastrointestinal fistula are rare but serious complications of severe acute pancreatitis(SAP).However,neither spontaneous gallbladder perforation nor cholecysto-colonic fistula has been reported in acalculous acute pancreatitis patients.CASE SUMMARY A 31-year-old male presenting with epigastric pain was diagnosed with hypertriglyceridemia-related SAP.He suffered from multiorgan failure and was able to leave the intensive care unit on day 20.Three percutaneous drainage tubes were placed for profound exudation in the peripancreatic region and left paracolic sulcus.He developed spontaneous gallbladder perforation with symptoms of fever and right upper quadrant pain 1 mo after SAP onset and was stabilized by percutaneous drainage.Peripancreatic infection appeared 1 mo later and was treated with antibiotics but without satisfactory results.Then multiple colon fistulas,including a cholecysto-colonic fistula and a descending colon fistula,emerged 3 mo after the onset of SAP.Nephroscopy-assisted peripancreatic debridement and ileostomy were carried out immediately.The fistulas achieved spontaneous closure 7 mo later,and the patient recovered after cholecystectomy and ileostomy reduction.We presume that the causes of gallbladder perforation are poor bile drainage due to external pressure,pancreatic enzyme erosion,and ischemia.The possible causes of colon fistulas are pancreatic enzymes or infected necrosis erosion,ischemia,and iatrogenic injury.According to our experience,localized gallbladder perforation can be stabilized by percutaneous drainage.Pancreatic debridement and proximal colostomy followed by cholecystectomy are feasible and valid treatment options for cholecysto-colonic fistulas.CONCLUSION Gallbladder perforation and cholecysto-colonic fistula should be considered in acalculous SAP patients. 展开更多
关键词 Acalculous severe acute pancreatitis Gallbladder perforation Cholecysto-colonic fistula Percutaneous drainage CHOLECYSTECTOMY Case report
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Expert consensus on emergency diagnosis and treatment procedures for acute upper gastrointestinal bleeding 被引量:1
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作者 jia-yuan dai +5 位作者 Lu Yin Jun Xu Joseph Harold Walline Chuan-Zhu Lv Xiao-Dong Zhao Xue-Zhong Yu 《Journal of Acute Disease》 2020年第6期231-243,共13页
Acute upper gastrointestinal bleeding is one of the most common life-threatening diseases.Standardized diagnosis and treatment of acute upper gastrointestinal bleeding are of great importance for improving the prognos... Acute upper gastrointestinal bleeding is one of the most common life-threatening diseases.Standardized diagnosis and treatment of acute upper gastrointestinal bleeding are of great importance for improving the prognosis.In 2015,the Emergency Physician Branch of the Chinese Medical Doctor Association updated an expert consensus statement on the emergency diagnosis and treatment procedures for acute upper gastrointestinal bleeding.Based on the 2015 consensus statement,members of the expert panel decided to reconvene and draw up a 2020 update on the advancements in the clinical care for acute upper gastrointestinal bleeding.The 2020 expert consensus statement is summarized in 10 sections:emergency assessment,diagnosis,stratified treatment,emergency treatment,comprehensive assessment,medication management,endoscopy,interventional radiology,multidisciplinary treatment,and evaluation of prognosis.The consensus statement is based on experts'opinions combined with the latest relevant medical evidence. 展开更多
关键词 DIAGNOSIS treatment STATEMENT
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A Woman with Psychogenic Non-epileptic Seizures and Pelvic Mass
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作者 Teng-da Xu Sheng-yong Xu jia-yuan dai 《Chinese Medical Sciences Journal》 CAS CSCD 2016年第3期203-205,206,共4页
MOST cases of encephalitis are caused by viruses but a few have an immunological basis, such as paraneoplastic encephalitis, with specific antibodies identified. One recently characterized encephalitis caused by antib... MOST cases of encephalitis are caused by viruses but a few have an immunological basis, such as paraneoplastic encephalitis, with specific antibodies identified. One recently characterized encephalitis caused by antibodies is anti-N- methyl-D-aspartate (NMDA) receptor encephalitis. It is a form of paraneoplastic limbic encephalitis associated with ovarian teratoma and has recently been described.The NMDA receptor mediates excitatory neurotransmission. It is important for synaptic plasticity, and thus for higher function such as learning and memory. This disorder results in prominent psychiatric symptoms followed by a rapid decline of the level of consciousness, central hypoventilation, seizures, involuntary movements and dysautonomia. 展开更多
关键词 psychogenic seizure limbic encephalitis ovarian teratoma anti-N-methyl-D-aspartate receptor encephalitis emergency treatment
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