Pyogenic spondylitis following endoscopic submucosal dissection for early gastric cancer.
Pyogenic spondylitis following endoscopic submucosal dissection for early gastric cancer.
复制标题
早期胃癌内镜粘膜下剥离术后的化脓性脊柱炎。
DOI：
10.1136/bcr-2022-249614
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Nakase H.
中科院分区：
文献类型：
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作者：
Takai S;Sudo G;Yawata A;Nakase H.
一名80多岁的男性，有糖尿病和主动脉瓣置换术史，因早期胃癌转诊到我院治疗，并接受了内镜下粘膜下剥离术（ESD）。ESD后3天，患者出现腰痛和发热（38.7°）。我们最初考虑了与胃ESD相关的不良事件，如延迟穿孔。此外，由于他的病史，怀疑血栓栓塞和感染性心内膜炎。然而，没有提示这些疾病的显著发现。最后，根据血培养和MRI结果，作出化脓性脊柱炎（PS）的诊断。我们给予抗生素治疗12周，患者病情好转，无神经功能障碍。该病例表明胃ESD后可能发生菌血症和随后的PS。医生不应忽视ESD后与各种不良事件相关的患者体征。
A man in his 80s who had a history of diabetes mellitus and aortic valve replacement was referred to our hospital for treatment of early gastric cancer and underwent endoscopic submucosal dissection (ESD). Three days after ESD, the patient presented with low back pain and fever (38.7°). We initially considered adverse events associated with gastric ESD such as delayed perforation. Moreover, thromboembolism and infectious endocarditis were suspected because of his medical history. However, there were no remarkable findings suggestive of these diseases. Finally, based on the results of blood cultures and MRI, the diagnosis of pyogenic spondylitis (PS) was made. We administered antibiotics for 12 weeks, and the patient improved without neurological impairments. This case indicates that bacteraemia and subsequent PS can occur following gastric ESD. Physicians should not overlook the patient’s physical signs related to various adverse events after ESD.