ID 53258
Sort Key
8
Title Alternative
Cholelithiasis with a cholecystoduodenal fistula complicated with paroxysmal nocturnal hemoglobinuria
FullText URL
Thumnail 127_35.pdf 943 KB
Author
Kato, Takuya
Matsukawa, Hiroyoshi
Shiozaki, Shigehiro
Fuji, Tomokazu
Fujiwara, Yasuhiro
Ninomiya, Motoki
Abstract
 In cases of paroxysmal nocturnal hemoglobinuria (PNH), attention must be paid to potential complications such as thrombosis and hemolysis due to perioperative stress and infection from complement activation. Here we present the case of a 61-year-old Japanese woman with PNH. We made the diagnosis of PNH when she was 28 years old, and we administered repeated steroid medication and erythrocyte transfusion. The patient's cholecystocholedocholithiasis with a cholecystoduodenal fistula was diagnosed based on a survey of the right hypochondriac pain. We performed endoscopic nasobiliary drainage (ENBD) for the prophylaxis of perioperative infection, plus a cholecystectomy and fistulectomy. There were no complications, including hemolysis attack, infection, thrombosis with irrigation erythrocyte transfusion, steroid cover, or the need for heparin administration during the perioperative period. The reduction of the complement activation is necessary in the perioperative management of PNH patients. The prevention of the development of acidosis and hypoxemia, the selection of washed red blood cells, steroid use, appropriate infection measures and thrombosis prophylaxis are all important for the prevention of complications.
Keywords
発作性夜間血色素尿症(PNH)(paroxysmal nocturnal hemoglobinuria (PNH))
胆嚢十二指腸瘻(cholecystoduodenal fistula)
溶血発作(hemolysis)
Note
症例報告 (Case Reports)
Publication Title
岡山医学会雑誌
Published Date
2015-04-01
Volume
volume127
Issue
issue1
Publisher
岡山医学会
Publisher Alternative
Okayama Medical Association
Start Page
35
End Page
39
ISSN
0030-1558
NCID
AN00032489
Content Type
Journal Article
Related Url
http://www.okayama-u.ac.jp/user/oma/
OAI-PMH Set
岡山大学
language
日本語
Copyright Holders
Copyright (c) 2015 岡山医学会
File Version
publisher
Refereed
True
DOI
NAID
Eprints Journal Name
joma
References
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