PDF(Pubmed)
Abstract：
We present a life-threatening case of postpartum acute necrotizing pancreatitis. The patient is a 37-year-old female with no past medical history who delivered a healthy baby boy via cesarean section. Twenty days later, she presented to the emergency department with acute onset of nausea, non-bloody vomiting, abdominal bloating, and epigastric pain radiating to the back. Less than 24 hours later, she progressed into septic shock despite aggressive resuscitation, requiring vasopressor support in the ICU. Initial CT imaging showed multiple patchy hypodensities throughout the pancreas consistent with severe necrotizing pancreatitis. Her hospitalization was further complicated by difficulty obtaining source control of her infection, Clostridium difficile, and nutritional deficiencies that resulted in gross anasarca. She was discharged from the hospital on day 59 after undergoing multiple percutaneous drain placements, IV antibiotics, and endoscopic gastrocystostomy with four pancreatic necrosectomies. Since discharge, the patient has required readmission twice for complications from her pancreatitis.
摘要：
我们提出了一个威胁生命的产后急性坏死性胰腺炎病例。患者是一名37岁的女性，没有既往病史，通过剖腹产分娩了一名健康的男婴。二十天后,她因急性恶心出现在急诊科，非血性呕吐,腹胀,上腹部疼痛放射到背部。不到24小时后,尽管进行了积极的复苏，她还是进展为感染性休克，在ICU需要加压药支持。最初的CT成像显示整个胰腺有多个斑片状低密度，与严重的坏死性胰腺炎一致。由于难以获得感染的来源控制，她的住院更加复杂，艰难梭菌,和营养缺乏导致严重的失踪症。在接受多次经皮引流后，她于第59天出院，IV抗生素，和内镜下胃囊吻合术伴4例胰腺坏死切除术。自放电以来，患者因胰腺炎并发症需要再次入院两次.
