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Medical Diagnosis 2021
乙肝肝硬化患者结肠癌致小肠梗阻1例
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Abstract:
本文报道了乙肝肝硬化患者结肠癌导致小肠梗阻1例。本例患者以急性小肠梗阻发病,梗阻部位与原发病灶部位不一致,且发病前无结直肠癌的相关临床症状,增加了诊断难度。患者术前Child-Pugh分级和MELD评分均提示低手术风险,但在术后仍然出现了肝功能不全。对于肝硬化患者应加强围术期的管理,必要时给予相应的干预和治疗,同时如何对肝硬化患者进行结直肠癌筛查需要进一步探讨。
A case of small bowel obstruction caused by colon cancer in a hepatitis B cirrhosis patient was re-ported. In this case, the patient developed acute small bowel obstruction, but the obstruction site was inconsistent with the primary lesion site. There were no clinical symptoms related to colorectal cancer before the onset, which increased the difficulty of diagnosis. Preoperative Child-Pugh score and MELD score suggested low surgical risk, but postoperative hepatic decompensation still occurred. For patients with cirrhosis, perioperative management should be strengthened, and corresponding intervention and treatment should be given if necessary. Meanwhile, how to screen colorectal cancer for patients with cirrhosis needs further discussion.
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