Seo Pyoung Ju, Kim Dong Min, Kang Myoung Su, Lee Soon Il, Kim Hong Ja
Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
Korean J Gastroenterol. 2005 Nov;46(5):409-12.
Pancreatic metastases are found in up to 40% of patients with small cell lung cancer, but metastasis-induced acute pancreatitis is rare. Treatment of metastasis-induced acute pancreatitis is initially supportive, but failure of conservative management are common. There are few reports on aggressive treatment with chemotherapy which lead to rapid clinical improvement and prolongation of survival in patients with metastasis-induced acute pancreatitis. We experienced a case of metastasis-induced acute pancreatitis in a patient with small cell lung cancer. Despite conservative treatment with dietary restriction and intravenous fluid supply, serum amylase levels increased persistently with severe abdominal pain. After chemotherapy with irinotecan and carboplatin, abdominal pain and serum amylase levels resolved dramatically.
在高达40%的小细胞肺癌患者中可发现胰腺转移,但转移引起的急性胰腺炎很少见。转移引起的急性胰腺炎的治疗最初是支持性的,但保守治疗失败很常见。关于用化疗进行积极治疗从而使转移引起的急性胰腺炎患者临床快速改善并延长生存期的报道很少。我们遇到了一例小细胞肺癌患者发生转移引起的急性胰腺炎的病例。尽管采用了饮食限制和静脉补液的保守治疗,但血清淀粉酶水平持续升高且伴有严重腹痛。在用伊立替康和卡铂化疗后,腹痛和血清淀粉酶水平显著缓解。