FullText URL K0005872_abstract_review.pdf K0005872_summary.pdf K0005872_fulltext.pdf K0005872_figure.pdf K0005872_supplemental figure.pdf
Author Fuji, Tomokazu|
Published Date 2019-03-25
Content Type Thesis or Dissertation
Grant Number 甲第5872号
Granted Date 2019-03-25
Thesis Type 博士(医学)
Grantor 岡山大学
language 英語
Title Alternative Cholelithiasis with a cholecystoduodenal fistula complicated with paroxysmal nocturnal hemoglobinuria
FullText URL 127_35.pdf
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)
Publication Title 岡山医学会雑誌
Published Date 2015-04-01
Volume volume127
Issue issue1
Start Page 35
End Page 39
ISSN 0030-1558
Related Url http://www.okayama-u.ac.jp/user/oma/
language 日本語
Copyright Holders Copyright (c) 2015 岡山医学会
File Version publisher
DOI 10.4044/joma.127.35
NAID 130005068351