2024-03-29T00:58:25Z
https://u-ryukyu.repo.nii.ac.jp/oai
oai:u-ryukyu.repo.nii.ac.jp:02016137
2022-10-31T07:51:08Z
1642838163960:1642838198944:1642838199408:1642838216134
1642838403551:1642838412624
[症例報告]Renal papillary necrosis : An autopsy case report and a brief review of the literature
Takeshima, Yoshitaka
Nakachi, Atsushi
Shimoji, Hideaki
Miyazato, Hiroshi
Muto, Yoshihiro
renal papillary necrosis
sepsis
radiation-associated proctocolitis
An 83-year-old Japanese woman was admitted to our surgical department for persistent rectal bleeding on July 11, 1997. The patient had received radiotherapy for uterine cervical cancer 3 years previously. Her performance status was grade 3, due to bilateral femoral fracture. Sixteen months after radiotherapy, the patient demonstrated slight rectal bleeding. Since her rectal bleeding was persistent and intractable, she underwent proctectomy with colostomy. The resected rectum histologically showed severe endoarteritis and she was diagnosed to have a radiation proctitis. She developed paralytic bowel obstruction on the 6th post operative day (POD) and renal dysfunction with signs of systemic inflammatory response syndrome on the 10th POD. On the 25th POD, she developed a sudden onset of hematemesis and hypovolemic shock. An emergency endoscopic examination showed bleeding from multiple shallow ulcers in the stomach (acute gastric mucosal lesion). Simultaneously the patient presented with clinical manifestations of sepsis. The patient finally expired due to multiple organ failure. The autopsy revealed clinically insidiously progressing bilateral renal papillary necrosis, which was considered to be the primary cause of her death. Microscopically multiple extensive necrosis areas were observed in the renal papilla.
論文
http://purl.org/coar/resource_type/c_6501
琉球医学会
Ryukyu Medical Association
2001
VoR
1346888X
0289-1530
AN10369445
琉球医学会誌 = Ryukyu Medical Journal
3
20
139
137
eng
open access
琉球医学会