PDF(Pubmed)
Abstract：
Acute pancreatitis is a pancreatic inflammatory disorder that often leads to multi-organ dysfunction associated with systemic inflammatory response. Optic neuropathy is an extremely rare ocular manifestation that can occur especially in alcoholic pancreatitis most likely due to ischemic complications and is a vision-threatening condition that has to be recognized early as it can cause permanent vision loss. In this case report, a 51-year-old lady, an occasional consumer of alcohol, post-cholecystectomy status, presented with severe abdominal pain of four days\' duration associated with multiple episodes of vomiting. She was diagnosed with moderate to severe acute pancreatitis and needed ionotropic support initially. She had improvement in gastrointestinal symptoms. However, she had left peri-orbital pain and lacrimation with blurring of vision on Day 11 of illness. Subsequently, an ophthalmic evaluation revealed optic disc oedema and a mild decrease in visual acuity but normal visual field and colour vision. Therefore, left optic neuropathy was diagnosed and a high-dose oral steroid was started on a tapering dose. Follow-ups after four and 12 weeks showed significant improvement in optic disc oedema and other symptoms. Therefore, though optic neuropathy is rarely reported in acute pancreatitis, it has to be considered in clinical practice along with Purtscher-like retinopathy, which presents with ocular symptoms in acute pancreatitis.
摘要：
急性胰腺炎是一种通常导致与全身性炎症反应相关的多器官功能障碍的胰腺炎性疾病。视神经病变是一种极为罕见的眼部表现，尤其是在酒精性胰腺炎中，最可能是由于缺血性并发症，并且是一种威胁视力的疾病，必须及早发现，因为它可能导致永久性视力丧失。在这个案例报告中,一位51岁的女士,偶尔的酒精消费者，胆囊切除术后的状态，表现为持续4天的严重腹痛，并伴有多次呕吐。她被诊断为中度至重度急性胰腺炎，最初需要离子型支持。她的胃肠道症状有所改善。然而,在患病的第11天，她因视力模糊而离开了眶周疼痛和流泪。随后，眼科评估显示视盘水肿，视力轻度下降，但视野和色觉正常。因此,诊断为左视神经病变,开始逐渐减量大剂量口服类固醇.4周和12周后的随访显示，视盘水肿和其他症状显着改善。因此,尽管视神经病变在急性胰腺炎中很少报道，它必须在临床实践中与Purtscher样视网膜病变一起考虑，表现为急性胰腺炎的眼部症状。
