Toshikuni Nobuyuki, Kai Kyohei, Sato Shizo, Kitano Motoko, Fujisawa Masayoshi, Okushin Hiroaki, Morii Kazuhiko, Takagi Shinjiro, Takatani Masahiro, Morishita Hirofumi, Uesaka Koichi, Yuasa Shiro
Department of Internal Medicine, Himeji Red Cross Hospital, 1-12-1 Shimoteno, Himeji 670-8540, Japan.
World J Gastroenterol. 2006 Oct 21;12(39):6397-400. doi: 10.3748/wjg.v12.i39.6397.
A 68-year-old man underwent cholecystectomy and choledochoduodenostomy for biliary obstruction and nephrectomy for a renal tumor. Based on clinical and histopathologic findings, autoimmune pancreatitis (AIP) was diagnosed. The renal tumor was diagnosed as a renal cell cancer. Steroid therapy was started and thereafter pancreatic inflammation improved. Five years after surgery, the patient was readmitted because of pyrexia in a preshock state. A Klebsiella pneumoniae liver abscess complicated by sepsis was diagnosed. The patient recovered with percutaneous abscess drainage and administration of intravenous antibiotics. Liver abscess recurred 1 mo later but was successfully treated with antibiotics. There has been little information on long-term outcomes of patients with AIP treated with surgery. To our knowledge, this is the second case of liver abscess after surgical treatment of AIP.
一名68岁男性因胆道梗阻接受了胆囊切除术和胆总管十二指肠吻合术，并因肾肿瘤接受了肾切除术。根据临床和组织病理学检查结果，诊断为自身免疫性胰腺炎（AIP）。肾肿瘤被诊断为肾细胞癌。开始使用类固醇治疗，此后胰腺炎症有所改善。术后五年，患者因处于休克前期发热再次入院。诊断为肺炎克雷伯菌肝脓肿并伴有败血症。患者通过经皮脓肿引流和静脉注射抗生素治疗后康复。1个月后肝脓肿复发，但通过抗生素治疗成功治愈。关于接受手术治疗的AIP患者的长期预后，相关信息较少。据我们所知，这是AIP手术治疗后发生肝脓肿的第二例病例。
