Origuchi N, Kimura W, Sawabe M, Muto T, Esaki Y
Department of Surgery, The University of Tokyo, Japan.
Surg Today. 1999;29(4):358-60. doi: 10.1007/BF02483063.
We present herein an autopsy case of 63-year-old Japanese man who died as a result of pancreatic abscess, suppurative pylethrombosis, and multiple liver abscesses that had developed 10 years after a pancreato- and cystojejunostomy with side-to-side anastomosis for chronic pancreatitis. Even after this operation, the patient had continued to consume excessive amounts of alcohol. He had first experienced back pain with leukocytosis 9 years after the operation, which relapsed the following year. Despite percutaneous transhepatic gallbladder drainage, his icterus had deteriorated into hepatic insufficiency. Computed tomographic scans of the abdomen had disclosed multiple liver abscesses. At autopsy, a pancreatic abscess and suppurative pylethrombosis as well as multiple liver abscesses were found. There have been few reported cases of such lethal complications developing after a pancreato- and cystojejunostomy for chronic pancreatitis. As the consumption of alcohol would have exacerbated the chronic pancreatitis, such patients should be strongly advised to abstain from drinking alcohol.
我们在此报告一例63岁日本男性的尸检病例，该患者因慢性胰腺炎行胰管空肠侧侧吻合术后10年出现胰腺脓肿、化脓性门静脉血栓形成和多发性肝脓肿而死亡。即使在这次手术后，患者仍继续大量饮酒。术后9年他首次出现背痛伴白细胞增多，次年复发。尽管进行了经皮经肝胆管引流，但他的黄疸仍恶化为肝功能不全。腹部计算机断层扫描显示有多个肝脓肿。尸检时发现了胰腺脓肿、化脓性门静脉血栓形成以及多个肝脓肿。慢性胰腺炎行胰管空肠吻合术后发生这种致命并发症的报道病例很少。由于饮酒会加重慢性胰腺炎，因此应强烈建议此类患者戒酒。
