Superior mesenteric artery syndrome (SMAS) involves duodenal obstruction caused by compression of the horizontal section of the duodenum between the superior mesenteric artery and abdominal aorta. Here, the experience of nursing a lactating patient with SMAS is summarized. Nursing care was performed according to a multiple therapy approach of treating the SMAS in addition to particular psychological factors that may be present during lactation. The patient underwent exploratory laparotomy under general anaesthesia, duodenal lysis, and abdominal aorta–superior mesenteric artery bypass with great saphenous vein grafting. The key nursing care included pain control, psychological care, positional therapy, observation and nursing care of fluid drainage and body fever, nutrition support and discharge health guidance. Through the above nursing methods, the patient was eventually able to return to a normal diet.
Background The clinical features of amoebic colitis resemble those of Inflammatory Bowel Disease (IBD), and therefore the risk of misdiagnosis is very high.Methods We retrospectively reviewed data of all amebic colitis cases admitted to Beijing Friendship Hospital from January 2015 to January 2020. Cases were diagnosed by clinical presentation, laboratory examinations, and colonoscopy with biopsy and histological examination. Results 16 patients were diagnosed with amebic colitis by colonoscopies accompanied by biopsies and microscopic examinations. At first, 12 (75%) patients were misdiagnosed with IBD. The cecum was the most common site of amebic colitis (100%), and the caecum and rectum were also involved in many lesions (68.75%). Multiple lesions of erosion and/or ulcers were recognized in all patients (100%). The features of endoscopic findings included multiple irregularly shaped ulcers and erosions with surrounding erythema, and the ulcers and erosions were covered by the white or yellow exudates. The intervening mucosae between the ulcers or erosions were normal. The features of the rectums can be divided to 2 types: in 6 patients (54.5%), the irregular ulcers or erosions covered with white or yellow exudates were observed in the rectum and the cecum, and the bloody exudates in the rectum were more severe than those in the cecum; in the other 5 patients (45.5%), rectal lesions were much less severe than those in the cecum, and small superficial erosions or reddened mucosa were observed in the rectal ampulla. All patients were diagnosed as detection of amebic trophozoites from HE-stained biopsy specimens. The number of trophozoites ranged from 1 /HPF to >50/HPF. Among 16 cases, mild architectural alteration of colon crypt was observed in 10 cases (62.5%), and serious architectural alteration of colon crypt was found which had a crypt branch in 1 case (16.7%). Cryptitis was observed in 12 cases (75%) and its severity was mild or moderate. No crypts abscesses were observed in all cases. Conclusions Colonoscopies with histological examinations are very important to diagnose amebic colitis. Detecting the amoebic trophozoites in the exudates by histological examination is vital. Sometimes a negative biopsy does not rule out amebiasis, repeated biopsies may be needed to make the diagnosis.
Backgroud The clinical features of amoebic colitis resemble those of inflammatory bowel Disease(IBD), and therefore the risk of misdiagnosis is very high.Objective The aim of this study was to analyse the characteristics of the endoscopic and pathological findings of amebic colitis and the lessons from our patients, which were useful for diagnosing the amebic colitis timely and avoiding the serious complications.Methods We retrospectively reviewed data of all amebic colitis admitted to Beijing Friendship Hospital from January 2015 to January 2020. Cases were diagnosed by clinical presentation, laboratory examinations, and colonoscopy with biopsy and histological examination. Results 16 patients were diagnosed with amebic colitis by the colonscopy accompanied by biopsy and microscopic examination. At first time, 12 (75%) patients were misdiagnosed as IBD. Cecum was the most common site of amebic colitis(100%), and the caecum and rectum were also involved in many lesions(68.75%). Multiple lesions of erosion and/or ulcer were recognized in all patients(100%).The features of endoscopic findings included multiple irregular shaped ulcers and erosions with surrouding erythema, and the ulcers and erosions were covered by the white or yellow exudates. The intervening mucosae between the ulcers or erosions were normal. The features of rectums can be divided to 2 types: in 6 patients(54.5%), the irregular ulcer or erosions covered with white or yellow exudates were observed in rectum and cecum, and the bloody exudates in rectum were more severe than those in cecum; in other 5 patients(45.5%), rectal lesions were much less severe than those in cecum, the small superficial erosion or reddened mucosa were observed in the rectal ampulla. All patients were diagnosed as detection of amebic trophozoites from HE-stained biopsy specimens. The number of trophozoites ranged from 1 /HPF to >50/HPF. Among 16 cases, mild architectural alteration of colon crypt were observed in 10 cases(62.5%), and serious architectural alteration of colon crypt was found which had crypt branch in 1 case(16.7%). Cryptitis was observed in 12 cases(75%) and its severity was mild or moderate. No crypts abscess was observed in all cases. Conclusions The colonoscopy with histological examination are very important to diagnose the amebic colitis. Detect the amoebic trophozoites in the esudates by histological examination is the vital. Sometimes a negative biopsy does not rule out amebiasis, repeated biopsies may be needed to make the diagnosis.
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