Sindrom spontanog curenja vazduha – veoma retka plućna komplikacija poremećaja u ishrani
Sažetak
Uvod. Poremećaje u ishrani odlikuju uporno nezadovoljstvo sopstvenim telom i nezdrava kontrola telesne mase. Sindrom curenja vazduha (SCV) koji se javlja spontano je retka ali potencijalno fatalna komplikacija višegodišnjeg poremećaja u ishrani, koji dovodi do pothranjenosti sa hipoproteinemijom. Prikazujemo mladića lečenog od anoreksije nervoze, kod koga se razvio težak oblik spontanog SCV. Prikaz bolesnika. Bolesnik star 25 godina je prvobitno lečen zbog problema sa poremećajem u ishrani po tipu uporne anoreksije nervoze. Namerno je izgubio oko 40 kg tokom prethodne četiri godine. Tokom bolničkog lečenja, bolesnik je iznenada dobio jak bol u trbuhu, zbog čega je hitno upućen hirurgu. Na odeljenje intenzivne nege primljen je iscrpljen, afebrilan, sa trbuhom ispod nivoa grudnog koša, difuzno bolno osetljivim, sa čujnom peristaltikom i petehijama na koži leđa, ruku i zidu grudnog koša. Urađena je kompjuterizovana tomografija torakoabdominalne regije, kojom je viđen vazduh u medijastinumu, u kičmenom kanalu, oko želuca, rektuma i u maloj karlici. Posle hitne laparotomije, urađena mu je drenaža trbušne duplje i intraoperativno ezofagogastroduodenoskopija. Bolesnik je postoperativno imao neurološke komplikacije. Posle uspešnog oporavka, ambulantno je psihijatrijski lečen i praćen tokom više meseci. Nadalje se nisu javljale slične tegobe. Zaključak. Bolesnike sa poremećajima u ishrani treba pažljivo pratiti, jer kod njih može doći do značajnog deficita proteina, sa spontanim SCV. Blagovremena dijagnoza i lečenje mogu sprečiti dalje somatsko pogoršanje i spasiti život bolesnika.
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