Department of Surgery, Kinki University School of Medicine, 377-2 Ohno-higashi, Osaka-sayama, 589-8511, Japan.
Surg Today. 2009;39(12):1083-5. doi: 10.1007/s00595-008-4105-z. Epub 2009 Dec 8.
Mild acute pancreatitis (AP) is rarely complicated by infection, and the value of prophylactic antibiotics is questionable. We report a case of mild AP complicated by infection, which developed within 1 week after the onset. A 66-year-old woman was referred to our hospital where a diagnosis of mild AP was made, based on laboratory data and computed tomography (CT) findings. She was managed conservatively with fluid resuscitation, intravenous antibiotics, and protease inhibitor. Her general condition improved initially, but a high fever redeveloped on hospital day 3. On hospital day 7, a repeat CT scan showed a peripancreatic fluid collection with gas, indicating peripancreatic abscess. A drainage operation was performed, and the organism cultured from the abscess was Escherichia coli. Her postoperative course was uneventful. We report this case to stress that infection may develop even in mild AP, and even in the early phase.
轻度急性胰腺炎(AP)很少合并感染,预防性使用抗生素的价值存在疑问。我们报告了一例轻度 AP 合并感染的病例,该感染在发病后 1 周内发生。一名 66 岁女性因发热和腹痛被转诊至我院,实验室数据和计算机断层扫描(CT)结果提示轻度 AP。她接受了液体复苏、静脉内抗生素和蛋白酶抑制剂的保守治疗。她的一般情况最初有所改善,但在住院第 3 天出现高热。在住院第 7 天,重复 CT 扫描显示胰周积液伴积气,提示胰周脓肿。进行了引流手术,从脓肿中培养出的病原体为大肠杆菌。她的术后过程平稳。我们报告这个病例是为了强调感染甚至可能在轻度 AP 中发生,并且可能在早期发生。