Ahmad Faheem Asem, Mahmud Sajid
Department of General Surgery, Hairmyres Hospital, East Kilbride, G75 8RG, United Kingdom.
JOP. 2010 Jan 8;11(1):61-3.
Orlistat is a pancreatic lipase inhibitor licensed for the treatment of obesity. As obesity rates increase and non-prescription dispensing of orlistat increases, an awareness of its adverse effects is of crucial importance as complications arise more frequently from increased use. Orlistat induced pancreatitis has been described only once previously, but without a diagnostic increase in serum amylase.
We report the case of two patients who developed severe acute abdominal pain and elevated pancreatic enzymes at 2 and 10 days after starting orlistat. In one case no alterative precipitant was identified. In the other, a predisposing history of pancreatic injury was present. In both cases all other contributory causes were excluded.
Our reports suggest orlistat can trigger drug induced acute pancreatitis in certain patients. For patients presenting with abdominal pain soon after commencing orlistat, a diagnosis of pancreatitis must be considered. We also recommend cautious use of orlistat in patients at risk of pancreatic injury.
奥利司他是一种被批准用于治疗肥胖症的胰脂肪酶抑制剂。随着肥胖率的上升以及奥利司他非处方配药的增加，鉴于其使用增多导致并发症更频繁出现，了解其不良反应至关重要。奥利司他诱发的胰腺炎此前仅被描述过一次，但血清淀粉酶未出现诊断性升高。
我们报告了两例患者的病例，他们在开始服用奥利司他后第2天和第10天出现严重的急性腹痛和胰腺酶升高。其中一例未发现其他诱发因素。另一例存在胰腺损伤的 predisposing 病史。在两例中，所有其他可能的病因均被排除。
我们的报告表明，奥利司他可在某些患者中引发药物性急性胰腺炎。对于开始服用奥利司他后不久出现腹痛的患者，必须考虑胰腺炎的诊断。我们还建议在有胰腺损伤风险的患者中谨慎使用奥利司他。 （注：“predisposing”这里可能是“易感的”之类意思，原词有误，推测可能是“predisposing”）
