Internal medicine (Tokyo, Japan) · 2023
Duodenal Diverticular Perforation Treated Conservatively: Reassessing Indications for Treatment.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Sasaki Yuri, Nakahodo Jun, Onishi Tomoko, Tachibana Ayu, Minami Ryogo, Noma Eriko, Moriguchi Yoshiaki, Tabata Hiroki, Shimizuguchi Ryoko, Takao Akinari, Shibata Satomi, Chiba Kazuro, Arakawa Takeo, Iizuka Toshiro, Kamisawa Terumi
Аннотация
A 59-year-old woman presented with a chief complaint of melena. She had no abdominal findings, such as tenderness or tapping pain. Laboratory tests revealed a white blood cell count of 5,300 cells/μL and C-reactive protein level of 0.07 mg/dL. Inflammation and anemia (hemoglobin 12.4 g/dL) were denied. Contrast-enhanced computed tomography (CT) revealed multiple duodenal diverticula and air surrounding a descending duodenal diverticulum. Based on these findings, duodenal diverticular perforation (DDP) was suspected. Oral food intake was stopped, and nasogastric tube feeding and conservative treatment with cefmetazole, lansoprazole, and ulinastatin were begun. On day 8 of hospitalization, follow-up CT revealed the disappearance of the air surrounding the duodenum, and the patient was discharged on day 19 after the resumption of oral feeding.