NEJM临床医学影像脊髓损伤患者的
2017-6-22 来源：不详 浏览次数：次CSCCM公众平台已开通评论功能，欢迎您阅读后在屏幕下方留下精彩评论，以实现重症医学同道们越来越好的交流。
ImagesinClinicalMedicineNeurogenicMegacoloninSpinalCordInjuryRukmaR.Govindu,MichelleKelleyNEnglJMed;:e45DOI:10./NEJMicmCopyright?MassachusettsMedicalSociety.A44-year-oldmanwitha20-yearhistoryofquadriplegiafromagunshotwoundtotheneckpresentedtotheemergencydepartmentwithsymptomsofaurinarytractinfection.Hismedicalhistoryincludedchronicmegacolonandneurogenicbladder,andhehadbeenadmittedtothehospitalmanytimesforthemanagementofurinarytractinfectionsandconstipation.Onphysicalexamination,hisabdomenwasdistended,soft,nontender,andtympanictopercussion,withnormalbowelsounds.Extremelylarge,intermittentwavesofperistalsiswerenoted(seevideo),andthepatientreportedmildcrampingandabloatingsensationinassociationwiththisfinding.Computedtomographyoftheabdomenrevealedmassivedilatationofthetransverse(PanelsAandB),descending,andsigmoidcolonofupto18cm.Therewasalsoasubstantialfecalburdenasaresultofneurogenicdysfunction(PanelsAandB,asterisks).Stoolsoftenersandlaxativeswereadministered,andthepatientwastoldtoavoidantimotilityagents.Megacolonisprevalentinpatientswithspinalcordinjuries,especiallyinolderpatientsandinthosewithinjuriesthathavebeenpresentformorethan10years.Complicationsofmegacolonincludeabdominal白癜风早期症状及治疗北京哪个专家治疗白癜风好
