[A case of cancer of the esophagus accompanied by postoperative fulminant hepatitis].
A 60-years-old male subject, who had complained of swallowing difficulties, was diagnosed as having cancer of the esophagus. No allergic reaction was noted in his history. Mechanical anastomosis connecting the gastric tract with the cervical esophagus was performed satisfactorily. During the operation, haemodynamics remained stable and in the absence of excessive bleeding, 5 bags of fresh frozen plasma were used. One day after the operation, however, marked abnormalities in liver function were observed and by the 11th day GOT and GPT levels had increased to 783 and 1,108, respectively. In addition, redness suggestive of drug rash was observed. Although steroid therapy, followed by plasma exchange therapy, was repeated four times, the patient died on day 21. Autopsy revealed that the patient suffered an acute form of fulminant hepatitis. Viral infection, drug treatment or surgical aggression is often considered to be the cause of this condition. In this subject, it is thought that the hepatic disorder was evoked by either the operation or drug treatment and that subsequently allergic reaction or immune abnormality caused the fulminant hepatitis.
Hirose
S
S
Funaki
H
H
Isomoto
T
T
Iizuka
T
T
D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D004342:Drug Hypersensitivity / Q000150:complications; D004938:Esophageal Neoplasms / Q000601:surgery*; D017809:Fatal Outcome; D006505:Hepatitis / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange / Q000009:adverse effects; D011183:Postoperative Complications; D013312:Stress, Physiological / Q000150:complications
D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase