PDF(Pubmed)
Abstract：
Introduction Acute pancreatitis can cause a wide variety of local complications, sometimes pretty unusual. In the present report, we present a rather unusual cause of biliary peritonitis on the background of acute pancreatitis. Case Presentation A 41-year-old female patient with biliary acute pancreatitis and concomitant choledocholithiasis required an urgent laparotomy due to signs of sepsis and peritoneal irritation after a trial of conservative management. During laparotomy, the diagnosis of biliary peritonitis was established. Surprisingly, a residual gallstone obstructing the common bile duct at the level of the ampulla was causing bile to reflux, through the common channel, into the main pancreatic duct and subsequently into a partially ruptured acute pancreatic necrotic collection. Conclusion Dealing with the unexpected is a constant challenge for the surgical team dealing with acute pancreatitis patients. Although deferring surgical intervention during the course of acute pancreatitis, as much as possible, is the ideal strategy, this is not always possible. Deciding the treatment strategy based on the patients\' clinical condition represents the most appropriate approach.
摘要：
急性胰腺炎可引起多种局部并发症，有时很不寻常。在本报告中，在急性胰腺炎的背景下，我们提出了一个相当不寻常的胆汁性腹膜炎的原因。病例介绍一名41岁的胆源性急性胰腺炎和合并胆总管结石的女性患者在进行保守治疗后，由于败血症和腹膜刺激的迹象，需要紧急剖腹手术。在剖腹手术中,诊断为胆源性腹膜炎。令人惊讶的是,残余的胆结石阻塞壶腹水平的胆总管导致胆汁回流，通过公共频道，进入主胰管，随后进入部分破裂的急性胰腺坏死集合。结论应对意外情况是应对急性胰腺炎患者的外科团队不断面临的挑战。尽管在急性胰腺炎的过程中推迟了手术干预，尽可能多,是理想的策略，这并不总是可能的。根据患者的临床状况决定治疗策略是最合适的方法。
