临床误诊误治2025，Vol.38Issue(15)：1-6,6.DOI:10.3969/j.issn.1002-3429.2025.15.001
腹膜透析患者妇科术后并发肠瘘误诊为腹膜透析相关性腹膜炎临床探讨
Clinical Discussion on the Misdiagnosis of Intestinal Fistula after Gynecological Surgery as Peritoneal Dialysis-related Peritonitis in Patients Undergoing Peritoneal Dialysis
摘要
Abstract
Objective To analyze the causes of misdiagnosis of intestinal fistula after gynecological surgery as peritoneal dialysis-associated peritonitis(PDAP)in patients undergoing peritoneal dialysis(PD)and to explore preventive measures.Methods A retrospective analysis was conducted on the clinical data of one PD patient with intestinal fistula after gynecological surgery who was admitted in August 2023.Results This patient presented with repeated abdominal pain for 4 d after gynecological surgery and was initially diagnosed with PDAP based on relevant catheter,the therapeutic effect was not obvious,and upper gastrointestinal bleeding occurred.Intestinal fistula was shown based on the patient's surgical history,clinical manifestations and abdominal imaging examinations.The misdiagnosis lasted 15 d.The family members of the patient requested conservative treatment.After active anti-infection,nutritional support and other symptomatic treatments,the patient eventually died due to ineffective treatment of septic shock.Conclusion The clinical manifestations and related laboratory tests of intestinal fistula are similar to those of PDAP,and misdiagnosis is more likely to occur.Clinicians should enhance their ability to identify the disease at an early stage,and closely integrate with clinical practice,to reduce misdiagnosis and lower the mortality rate.关键词
腹膜透析/妇科手术/肠瘘/误诊/腹膜透析相关性腹膜炎/诊断,鉴别/休克,脓毒性/预后Key words
peritoneal dialysis/gynecologic surgery/intestinal fistula/misdiagnosis/peritoneal dialysis-associated peritonitis/diagnosis,differential/shock,septic/prognosis引用本文复制引用
樊璐璐,罗阳燕,向洪玉,高芳..腹膜透析患者妇科术后并发肠瘘误诊为腹膜透析相关性腹膜炎临床探讨[J].临床误诊误治,2025,38(15):1-6,6.基金项目
成都市金牛区医学会肾脏专项课题重点项目(JNQN20-24) （JNQN20-24）
四川省医学科研青年创新课题计划(Q17024) （Q17024）
