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吐水性膵炎。急性壊死性膵炎のまれな合併症
Emphysematous Pancreatitis: A Rare Complication of Acute Necrotizing Pancreatitis.
PMID: 32523917 PMCID: PMC7279907. DOI: 10.12890/2020_001550.
抄録
吐水性膵炎は急性壊死性膵炎のまれな合併症であり，致命的なものである．背中に放射状に広がる上腹部痛，嘔吐と正常値の3倍以上の脂血症を合併して受診した61歳女性患者の放射線医学的観察例を報告する．入院4日目に病状の悪化を踏まえて実施した腹部CT検査では、気泡を伴う膵臓壊死を認めた。膵臓周囲の採取物を経皮的に穿刺した結果，膵気腫性膵炎と診断された．当院の患者の臨床的および生物学的経過は抗生物質治療により良好であった。
Emphysematous pancreatitis is a rare and fatal complication of acute necrotizing pancreatitis. We report a radioclinical observation of a 61-year-old female patient who consulted for epigastric pain radiating to the back, associated with vomiting and elevated lipasaemia more than 3 times the normal value. The abdominal computerized tomography (CT) scan carried out on the fourth day of hospitalization, based on worsening of the clinical condition, showed pancreatic necrosis associated with the presence of air bubbles. Percutaneous puncture of a peripancreatic collection was positive for A diagnosis of emphysematous pancreatitis was established. The clinical and biological evolution of our patient was favourable with antibiotic treatment.
学習ポイント:
肺気腫性膵炎は、急性壊死性膵炎のまれで致命的な合併症である。腹部CTは、空気のintraおよび/または/または膵周囲の存在に基づいて、この病理学の疑いを可能にします。
LEARNING POINTS: Emphysematous pancreatitis is a rare and fatal complication of acute necrotizing pancreatitis.Abdominal CT allows for suspicion of this pathology based on the intra- and/or peripancreatic presence of air.The diagnosis is confirmed by the isolation of the bacterial agent in peripancreatic needle aspiration fluid.
© EFIM 2020.