気胸手術後にSIRSから多臓器障害を合併した1例

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  • A SUCCESSFULLY SAVED PATIENT WITH PNEUMOTHORAX CAUSING MULTIPLE ORGAN FAILLURE FROM SIRS AFTER OPERATION

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SIRS is a condition of hypercytokinemia induced by various invasions and it can be a preparatory stage for occurrence of organ failure. This paper presents a successfully saved patient who developed multi organ failure from SIRS after a less invasive operation for pneumothorax.<br> A 19-year-old man was seen at the hospital because of left chest pain. A partial resection of the left lung was performed with a diagnosis of spontaneous pneumothorax due to partial collapse of the left lung apex. On the fourth hospital day a high fever (40°C), erythema and diarrhea occurred. Pseudomembranous enterocolitis was suspected and medical treatment was started, but no abnormality was detected on colonoscopy on the sixth hospital day. Impaired renal function and hepatic function, as well as thrombocytopenia appeared, and increases in blood endotoxin and IL-6 were shown. The patient was diagnosed as having multiple organ failure from SIRS. Hemodialysis with endotoxin absorption and administration of steroids and FOY were started and resulted in a successful outcome. The patient was discharged from the hospital on the 41st hospital day. On the 12th hospital day, abscess formation was confirmed in the subcutaneous portion where a thoracic drainage was inserted, and the culture of the abscessyielded a MRSA. However, the origin of SIRS remained obscure.

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