التفاصيل البيبلوغرافية
| العنوان: |
広範な壊疽を伴うフルニエ壊疽の1例 ; Extensive Fournier's gangrene: a case report |
| المؤلفون: |
三浦, 克紀, 小林, 恭, 松井, 善之, 藤川, 慶太, 福澤, 重樹, 添田, 朝樹, 竹内, 秀雄 |
| المساهمون: |
MIURA, Katsuki, KOBAYASHI, Takashi, MATSUI, Yoshiyuki, FUJIKAWA, Keita, FUKUZAWA, Shigeki, SOEDA, Asaki, TAKEUCHI, Hideo |
| بيانات النشر: |
泌尿器科紀要刊行会 |
| سنة النشر: |
2000 |
| المجموعة: |
Kyoto University Research Information Repository (KURENAI) / 京都大学学術情報リポジトリ |
| مصطلحات موضوعية: |
Fournier's gangrene, Anorectal infection, Intestinal necrosis, Peritonitis, 494.9 |
| الوصف: |
症例は51歳男で, 感冒様症状・下痢・腹痛を主訴に他院を受診し, 急性腸炎の診断で入院した.翌朝, 血圧が低下し筋性防御が出現したため自施設への転院となった.転院時, 会陰部は強い腐敗臭を放っており, 陰嚢から左臀部にかけて黒色の壊死を認めた.腹部単純X線写真では腸管が著明に拡張し, 麻痺性イレウスの像を呈していた.X線CTで陰嚢内・腹壁皮下組織・直腸膀胱周囲・後腹膜腔にガス像を認めた.これらの所見からFournier壊疽及び急性腹膜炎と診断し, 緊急デブリドマンと開腹術を行った.壊疽は肛門直腸周囲で特に激しく, 後腹膜腔へと続いていた.腹腔内には強烈な悪臭を放つ膿性の腹水が貯留し, 腹膜や小腸の一部にも壊死が及んでいた.術後は抗生剤やメシル酸ナファモスタット, カテコラミン等の投与を続けたが好転せず, 手術から29日目に多臓器不全のため死亡した.摘出標本と腹水からBacteroides fragilis, α-Streptococcus, Enterococcus faecalisが培養された ; We report a case of extensive Fournier's gangrene that could not be rescued despite emergent debridement. A 51-year-old man presented at another hospital with cough, diarrhea and abdominal pain. He was diagnosed with acute enteritis and hospitalized. The next morning, he became severely hypotensive and his scrotum was swollen and black. The perineal skin also was black. Septic shock and disseminated intravascular coagulation were suspected. He was transferred to our emergency room, and was immediately diagnosed with Fournier's gangrene and acute peritonitis. Computed tomographic scan revealed soft-tissue gas in the scrotum, the retroperitoneal cavity and the abdominal wall. Emergent debridement and laparotomy was performed. Gangrene was also seen at the intestinal wall and the peritoneum, however, resection of intestine was not done because of his poor performance status. Although potent antibiotics and catecholamine were administered, he died of multiple organ failure 29 hours after the operation. This is the first case of Fournier's gangrene extending into the abdominal cavity reported in the Japanese literature. |
| نوع الوثيقة: |
report |
| وصف الملف: |
application/pdf |
| اللغة: |
Japanese |
| تدمد: |
0018-1994 |
| Relation: |
http://hdl.handle.net/2433/114293; AN00208315; 泌尿器科紀要; 46; 429; 431; Acta urologica Japonica; Hinyokika Kiyo |
| الاتاحة: |
http://hdl.handle.net/2433/114293 |
| رقم الانضمام: |
edsbas.F9D1DD61 |
| قاعدة البيانات: |
BASE |