PDF(Pubmed)
Abstract：
Diabetic myonecrosis is a rare and poorly understood complication of long-standing, inadequately controlled diabetes mellitus. Theoretical mechanisms contributing to the pathophysiology of diabetic myonecrosis include microvascular complications due to advanced glycation end-products, ischemia-reperfusion injuries, and dysregulated coagulation-fibrinolysis activity. Case reports of diabetic myonecrosis most commonly describe diabetic patients with chronically poor glycemic control who experience isolated swelling and severe pain in a unilateral lower limb with no signs of infection or systemic toxicity. Due to the rarity of this condition, there are currently no treatment guidelines. This case describes a 58-year-old male with a history of uncontrolled diabetes who presented with diabetic ketoacidosis with mixed hypovolemic and septic shock. Diabetic myonecrosis was incidentally discovered in the patient\'s right latissimus dorsi with CT imaging and subsequent surgical exploration. Spontaneous diabetic myonecrosis may mimic several other serious conditions and elicit suboptimal management strategies, particularly in the context of atypical presentations.
摘要：
糖尿病性心肌坏死是一种罕见且鲜为人知的长期并发症，糖尿病控制不充分。促进糖尿病性心肌坏死病理生理学的理论机制包括由于晚期糖基化终产物引起的微血管并发症。缺血再灌注损伤，和凝血-纤溶活性失调。糖尿病性心肌坏死的病例报告最常描述长期血糖控制不佳的糖尿病患者，其单侧下肢出现孤立性肿胀和剧烈疼痛，没有感染或全身毒性的迹象。由于这种情况的罕见，目前没有治疗指南。该病例描述了一名58岁的男性，患有不受控制的糖尿病病史，他患有糖尿病酮症酸中毒并伴有低血容量和感染性休克。通过CT成像和随后的手术探查，在患者的右背阔肌偶然发现了糖尿病性肌坏死。自发性糖尿病性心肌坏死可能模仿其他几种严重疾病，并引发次优管理策略。特别是在非典型演示的背景下。
