internal med

内部医疗
  • 文章类型: Case Reports
    急性结肠假性梗阻(ACPO),或者奥格尔维综合征,是无机械性梗阻的急性结肠扩张;最常见于重病或术后患者。虽然这种综合征没有明确的病理生理学,当盲肠和右结肠扩张而没有物理阻塞时,它被诊断。这种情况可导致穿孔和肠缺血。Ogilvie综合征具有相对较高的发病率和死亡率。ACPO的诊断通常可能由于其模糊的症状而被错过,例如腹胀,腹胀,腹痛,恶心和呕吐,还有严重的便秘.我们报告了一名82岁的女性患者,该患者具有ACPO的独特诊断,或者奥格尔维综合征,被严重便秘的诊断所掩盖。此病例强调了保持高怀疑指数和早期诊断可能迅速变得危险的症状的重要性。
    Acute colonic pseudo-obstruction (ACPO), or Ogilvie\'s syndrome, is an acute colonic dilatation without mechanical obstruction; it is most commonly seen in severely ill or postoperative patients. While this syndrome has no clear pathophysiology, it is diagnosed when the cecum and right colon expand without physical obstruction. This condition can lead to perforation and intestinal ischemia. Ogilvie\'s syndrome is associated with a relatively high morbidity and mortality rate. The diagnosis of ACPO can be often missed due to its vague symptoms such as bloating, abdominal distention, abdominal pain, nausea and vomiting, and severe constipation. We report the case of an 82-year-old female patient who had a unique diagnosis of ACPO, or Ogilvie\'s syndrome, overshadowed by the diagnosis of severe constipation. This case highlights the importance of maintaining a high index of suspicion and early diagnosis of symptoms that can rapidly become dangerous.
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  • 文章类型: Case Reports
    蜘蛛咬伤,包括隐居蜘蛛的叮咬(Loxosceles,也被称为棕色蜘蛛),通常会导致局部症状;然而,文献中也报道了严重的全身症状.蜘蛛咬伤的管理是基于症状。在涉及血管性水肿发展的严重病例中,溶血性贫血,皮肤坏死合并细菌感染或弥散性血管内凝血,抗生素,类固醇,输血,和血浆置换也可能发挥作用。我们介绍了一例棕色隐士蜘蛛咬伤,导致有症状的溶血性贫血和黄疸,需要输血。
    Spider bites, including the bites of recluse spiders (Loxosceles, also known as brown spiders), usually lead to local symptoms; however, severe systemic symptoms have also been reported in the literature. Management of spider bites is based on symptoms. In severe cases involving the development of angioedema, hemolytic anemia, skin necrosis with superimposed bacterial infection or disseminated intravascular coagulation, antibiotics, steroids, blood transfusions, and plasma exchange may also play a role. We present a case of a brown recluse spider bite resulting in symptomatic hemolytic anemia and jaundice requiring blood transfusion.
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