胆道闭锁伴巨细胞病毒感染、先天性心脏病和肺炎:病例报告

Gracia Dewi, Setia Budi Salekede, Sri Hardiyanti Putri, Ninny Meutia Pelupessy, Mokhammad Ikhsan, Amiruddin Laompo
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引用次数: 0

摘要

胆道闭锁(BA)是一种胆道梗阻疾病。葛西肠管造口术(KPE)是一种治疗方法。本研究旨在确定伴有其他基础疾病的胆道闭锁患者接受 Kasai 手术的成功率和预后。这是一项描述性病例研究。我们报告了一名 2 个月零 11 天的男孩,从一周大起全身黄疸,大便呈腻子状,小便颜色深。老人面容,黄疸,肋骨木琴状,肋下回缩,啰音,持续性心脏杂音,消瘦。总胆红素、直接胆红素、SGOT、SGPT 和γ GT 增高。虽然进行了卡萨伊手术,但并没有明显改善他的病情,因为手术是在他 4 个月零 8 天时进行的,当时他患有肝硬化、败血症、肺炎和营养不良。巨细胞病毒(CMV)感染和急性先天性心脏病也加重了他的术前状况。葛西肠管造口术是治疗胆道闭锁的一种方法,但我们的患者被诊断为胆道闭锁,同时伴有巨细胞病毒感染、先天性心脏病或肺炎,因此该手术并不适合这种情况,而且死亡率比单纯的胆道闭锁更高。手术时的年龄也会影响预后。
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Biliary Atresia with Cytomegalovirus Infection, Congenital Heart Disease and Pneumonia: A Case Report
Biliary atresia (BA) is a condition of biliary obstruction. Kasai portoenterostomy (KPE) is a treatment option. The aim to determine the success rate of kasai procedure and prognosis in BA patients with other underlying diseases. This is a descriptive case study research. We report a boy, 2 months and 11 days with jaundice all over his body since one week old; putty stool, and dark urine. Old man's face, icteric, rib xylophone, subcostal retraction, rales, continuous heart murmur, and wasting. Total and direct bilirubin, SGOT, SGPT, and gamma GT are increased. A Kasai surgical procedure was carried out, but did not significantly improve his condition because the operation was performed at the age of 4 months and 8 days with liver cirrhosis, sepsis, pneumonia, and malnutrition. Cytomegalovirus (CMV) infection and acyanotic congenital heart disease also worsened his preoperative condition. Kasai portoenterostomy is a method of managing biliary atresia, but our patient was diagnosed with biliary atresia accompanied by CMV infection, congenital heart disease, or pneumonia, so the procedures not enough for this condition, and mortality rate is higher than biliary atresia alone. Age at surgery time also influences the prognosis.
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