具有蛋白丢失性肠病的家族性腺瘤性息肉病(FAP)是一种罕见的疾病,难以医学治疗。一名74岁的女性患者因厌食症而被转诊到我们医院。下胃肠镜检查显示从升结肠到直肠的多个腺瘤和乙状结肠和降结肠的腺癌。实验室检查结果显示低蛋白血症(白蛋白1.6mg/dl)。使用99mTc-HSAD的蛋白质渗漏闪烁显像术发现结肠有蛋白质渗漏。尽管进行了高热量输注,营养状况未得到改善,需要输入白蛋白.患者接受了腹腔镜全结直肠切除术,回肠袋-肛门吻合术,和临时回肠造口术。她的术后病程良好,低蛋白血症在几周内恢复正常。患者接受了临时回肠造口术逆转。在这里,我们报告了一例FAP伴蛋白丢失性肠病的病例,该病例接受了腹腔镜全直肠结肠切除术,这导致了蛋白质泄漏和癌症治疗的改善。
Familial adenomatous polyposis (FAP) with protein-losing enteropathy is a rare disorder and is difficult to treat medically. A 74-year-old female patient was referred to our hospital with a chief complaint of anorexia. Lower gastrointestinal endoscopy showed multiple adenomas from the ascending colon to the rectum and adenocarcinoma in the sigmoid colon and descending colon. Laboratory findings showed hypoalbuminemia (albumin 1.6 mg/dl). Protein leak scintigraphy using 99mTc-HSAD found a protein leak from the colon. Although hypercaloric infusion was administered, the nutritional status was not improved and albumin transfusion was required. The patient underwent laparoscopic total proctocolectomy, ileal pouch-anal anastomosis, and temporary ileostomy. She had a good postoperative course and the hypoalbuminemia normalized in a few weeks. The patient underwent temporary ileostomy reversal. Here we report a
case of FAP with protein-losing enteropathy who underwent laparoscopic total proctocolectomy, which resulted in improvement of the protein leak as well as cancer treatment.