一名患有终末期肾病的年轻女性因包裹性腹膜硬化症导致小肠阻塞:病例报告。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-10-28 DOI:10.12659/AJCR.945398
Sahil M Patel, Vashistha M Patel, Shreya V Patel, Samarth M Patel, Lauren L Pacheco
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引用次数: 0

摘要

背景:包裹性腹膜硬化症(EPS)是腹膜透析(PD)的一种危及生命的并发症。其特点是纤维膜部分或全部包裹小肠,是小肠梗阻(SBO)的罕见病因。在此,我们介绍一例因 EPS 而导致 SBO 的年轻女性病例,她有腹膜透析病史。病例报告:一名 37 岁女性,患有终末期肾病,继发于未控制的高血压,之前曾服用过 PD,因 1 周顽固性恶心和呕吐伴弥漫性腹痛到急诊科就诊。腹部计算机断层扫描显示小肠被纤维膜包裹,小肠随访显示有 SBO。她被诊断为腹膜透析引起的继发性三期 EPS。她开始服用泼尼松和他莫昔芬,症状很快得到缓解。不幸的是,由于多次复发 SBO,她目前正在接受手术治疗方案的评估。结论 本报告介绍了一例 EPS 病例,这是一种罕见的腰椎间盘突出症并发症,需要早期诊断和治疗,以防止潜在的致命后果。治疗重点应放在治疗基础疾病、优化营养、根据疾病状态和禁忌症使用皮质类固醇或他莫昔芬(单独或联合使用),以减少复发性 SBO。保守治疗失败后可能需要进行手术评估。
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Encapsulating Peritoneal Sclerosis Leading to Small Bowel Obstruction in a Young Woman with End-Stage Renal Disease: A Case Report.

BACKGROUND Encapsulating peritoneal sclerosis (EPS) is a life-threatening complication of peritoneal dialysis (PD). It is characterized by a fibrous membrane partially or totally encasing the small bowel and is a rare cause of small bowel obstruction (SBO). Here we present a case of a young woman with a history of PD presenting with SBO due to EPS. CASE REPORT A 37-year-old woman with end-stage renal disease secondary to uncontrolled hypertension previously on PD presented to the emergency department for evaluation of 1 week of intractable nausea and vomiting associated with diffuse abdominal pain. Computed tomography of the abdomen showed findings consistent with a fibrous membrane encapsulating the small bowel and a small bowel follow-through revealed an SBO. She was diagnosed with secondary stage 3 EPS due to PD. She was started on prednisone and tamoxifen with quick resolution of her symptoms. Unfortunately, due to numerous recurrent SBOs, she is now being evaluated for surgical treatment options. CONCLUSIONS This report has presented a case of EPS, a rare complication of PD, which requires early diagnosis and management to prevent potentially fatal consequences. Management should focus on treating the underlying condition, optimizing nutrition, and using corticosteroids or tamoxifen (alone or in combination) depending on disease state and contraindications, with the aim of reducing recurrent SBOs. Failure of conservative management may require surgical evaluation.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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