徳島大学 教育・研究者情報データベース(EDB)

1. (英) Kayo Hirose

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2. (英) Masao Hirose

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3. 田中 克哉([徳島大学.大学院医歯薬学研究部.医学域.医科学部門.外科系.麻酔・疼痛治療医学]/[徳島大学.病院.診療科.脳·神経·精神科])

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4. 川人 伸次([徳島大学.大学院医歯薬学研究部.歯学域.口腔科学部門.臨床歯学系.歯科麻酔科学])

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5. 玉置 俊晃

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6. 大下 修造

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(英) Perioperative management of severe anorexia nervosa.

(英) As the prevalence of anorexia nervosa (AN) increased, surgery in severe AN patients also increased in the 2000s. We experienced a surgical case of a patient with severe AN, showing an extremely low BMI of 8.6 kg m(-2). We investigated the problems associated with this case and propose criteria to manage severe AN. We endeavour to report on the perioperative management of rare and severe symptoms and surgical indications of severely malnourished patients. All published reports were identified through comprehensive searches using PubMed, BioMedLib, and the Japan Medical Abstracts Society with the following terms and keywords: 'anorexia nervosa', 'eating disorder', 'hypoglycaemia', 'leucocytopaenia', 'gelatinous bone marrow', 'surgery', and 'operation'. In cases of AN with a BMI under 13 kg m(-2), marked hypoglycaemia, leucocytopaenia <3.0×10(9) litre(-1), or both, potentially fatal complications frequently occur. Accordingly, patients need strict nutritional support to avoid re-feeding syndrome until surgery. During the course of anaesthesia, careless loading of glucose or catecholamine may lead to disturbance of electrolytes or fatal arrhythmia. Intensive care and early feeding as soon as possible after surgery are important to prevent surgical site infection. Although not many perioperative cases of AN have been reported, clinicians must be aware of the danger and the causes of mortality in critical cases. Thus, the decision to undertake surgery must be taken carefully and close perioperative coordination among physicians, surgeons, psychiatrists, anaesthesiologists, and intensivists is essential.

1. (英) Adult
2. 麻酔(anesthesia)
3. (英) Anorexia Nervosa
4. (英) Female
5. (英) Fractures, Bone
6. (英) Heart Diseases
7. (英) Humans
8. (英) Hypoglycemia
9. 低体温(hypothermia)
10. (英) Intraoperative Complications
11. (英) Male
12. (英) Malnutrition
13. (英) Nutritional Support
14. (英) Perioperative Care
15. (英) Postoperative Complications
16. (英) Surgical Procedures, Operative
17. (英) Surgical Wound Infection

1. (英) PublicationType: Case Reports

2. (英) PublicationType: Journal Article

3. (英) PublicationType: Research Support, Non-U.S. Gov't

4. (英) PublicationType: Review