临床误诊误治2017，Vol.30Issue(7)：43-46,4.DOI:10.3969/j.issn.1002-3429.2017.07.014
Budd-Chiari综合征误诊致截肢术后创面长期不愈并文献复习
Long-term Wound Disunion after Amputation Due to Misdiagnosis of Budd-Chiari Syndrome: a Case Report and Literature Review
摘要
Abstract
Objective To improve understanding, diagnosis and treatment for Budd-Chiari syndrome (BCS) in order to avoid misdiagnosis and mistreatment.Methods Clinical data of one long-term misdiagnosed patient with BCS and repeated wound infection after amputation of lower limb was retrospectively analyzed.Atypically clinical manifestation of BCS and causes of long-term misdiagnosis and mistreatment were analyzed.Results A middle-aged male was transmitted from burn department due to hospital acquired pneumonia(HAP).The patient had been diagnosed as having hepatocirrhosis on account of seroperitoneum in local hospital 20 years ago, and seroperitoneum had disappeared without systematic treatment.The patient underwent middle left thigh amputation in local hospital 9 months ago because of trauma, but the wound could not heal.He was transferred to burn department in our hospital 7 months ago, but the wound still remained unhealed after several times of debridement and wound dressing treatments.He was transferred to our department at the onset of HAP 1 week ago.Obstructions of hepatic venous return and inferior vena cava return by physical examination.BCS was confirmed after examinations such as abdominal ultrasonography, abdominal enhanced CT scan and inferior vena cavography.Sacculus dilation of inferior vena cava was performed, and the postoperative drainage volume of left thigh wound was decreased.The drainage tube was removed successfully 2 weeks later, and the wound healed gradually.Conclusion BCS can be easily misdiagnosed due to its atypically clinical manifestation.Clinicians should consider the possibility of vascular diseases for patients with similar clinical manifestation to hepatocirrhosis and long-term lower limb wound disunion, and related examinations such as angiography are necessary to avoid misdiagnosis and mistreatment.关键词
Budd-Chiari综合征/误诊/肝硬化/截肢术/手术后并发症/肺炎/球囊扩张术Key words
Budd-Chiari syndrome/Misdiagnosis/Hepatocirrhosis/Amputation/Postoperative complication/Pneumonia/Sacculus dilation分类
医药卫生引用本文复制引用
程洋,戴丽,夏国光..Budd-Chiari综合征误诊致截肢术后创面长期不愈并文献复习[J].临床误诊误治,2017,30(7):43-46,4.基金项目
首都卫生发展科研专项项目(216-1-4071) （216-1-4071）
