原发胆汁淤积性肝硬变合并乳糜胸老年患者1例

One elderly case of primary biliary cirrhosis complicated with chylothorax

摘要:

本文回顾了1例88岁男性原发胆汁淤积性肝硬变合并乳糜胸患者的诊治。患者以发热、咳嗽、咯痰伴喘憋为首发症状,入院后发现胸水并确诊为真性乳糜胸。排除了肿瘤、结核等乳糜胸的常见病因后,结合腹部CT及抗线粒体抗体M2亚型阳性,考虑为原发胆汁淤积性肝硬变导致乳糜胸形成。在内科保守治疗效果不佳的情况下,积极采取手术治疗,术后患者恢复好,多次复查胸片未见胸水生长。希望通过本病例,提高临床医师对老年乳糜胸的认识,做到早期诊断、综合治疗,以延长患者生存时间。

Abstract:

In this article, we retrospectively reported the successful diagnosis and treatment for a 88-year-old primary biliary cirrhosis patient with chylothorax. He initially presented with fever, cough, hemoptysis and shortness of breath, then he was found with pleural effusion and diagnosed with real chylothorax after admission. After exclusion of some common reasons, such as tumor, tuberculosis and so on, he was considered to be diagnosed as chylothorax secondary to primary biliary cirrhosis with the aids of abdominal CT scanning and positive anti-mitochondrial antibody M2. Surgical treatment was given in the case that conservative treatment of internal medicine was not effective. After surgical treatment, the patient recovered well and chylothorax was not recurrent in multiple chest X-ray examinations. This report aims to promote the physician’s awareness for chylothorax in the elderly, so that the early diagnosis and general treatment is performed to prolong the patient’s survival time.