Kvinlaug Kylie, Kriegler Stefan, Moser Michael
Department of Surgery, University of Saskatchewan, and Division of General Surgery, Royal University Hospital, Saskatoon, Saskatchewan, Canada.
Pancreas. 2009 Aug;38(6):667-71. doi: 10.1097/MPA.0b013e3181a9f12a.
Emphysematous pancreatitis is characterized by the presence of intraparenchymal pancreatic air in the setting of necrotizing pancreatitis. Mortality and morbidity rates approach approximately 40% and 100%, respectively. Traditionally, emphysematous pancreatitis was an indication for surgical intervention. The purpose of this review was to discuss our experience with nonoperative management of emphysematous pancreatitis.
Between July 2005 and August 2007, 5 patients with emphysematous pancreatitis were admitted to Royal University Hospital (Saskatoon, Saskatchewan, Canada). The cases are described in the context of the current literature.
The 5 male patients ranged in age from 50 to 77 years. Four required at least 1 week in the intensive care unit. All 5 cases of emphysematous pancreatitis went on to be treated successfully with nonoperative management. Furthermore, after a minimum of 1-year follow-up, they remain out of hospital and continue to do well.
Our data suggest that emphysematous pancreatitis may be a favorable subtype of severe pancreatitis. In well-selected patients, nonoperative management with aggressive antibiotic treatment and nutritional support may suffice.
气肿性胰腺炎的特征是在坏死性胰腺炎背景下出现胰腺实质内积气。其死亡率和发病率分别约为40%和100%。传统上，气肿性胰腺炎是手术干预的指征。本综述的目的是讨论我们对气肿性胰腺炎非手术治疗的经验。
2005年7月至2007年8月期间，5名气肿性胰腺炎患者入住加拿大萨斯喀彻温省萨斯卡通市皇家大学医院。结合当前文献对这些病例进行描述。
5名男性患者年龄在50至77岁之间。4名患者在重症监护病房至少需要治疗1周。所有5名气肿性胰腺炎病例均通过非手术治疗成功治愈。此外，经过至少1年的随访，他们均已出院且状况良好。
我们的数据表明，气肿性胰腺炎可能是重症胰腺炎的一种有利亚型。对于精心挑选的患者，积极的抗生素治疗和营养支持的非手术治疗可能就足够了。
