[一例由急性主动脉夹层引起的重症急性胰腺炎和缺血性胃病]

[A case of severe acute pancreatitis and ischemic gastropathy caused by acute aortic dissection].

作者信息

Umeda Ikumi, Hayashi Tsuyoshi, Ishiwatari Hirotoshi, Yoshida Makoto, Miyanishi Kouji, Sato Yasushi, Kofune Masayoshi, Takimoto Risyu, Kato Junji, Meguro Makoto, Hirata Kouichi

机构信息

Fourth Department of Internal Medicine, Sapporo Medical University.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 2011 Jan;108(1):103-10.

PMID:21212601

Abstract

A 49-year-old man presented with chest pain and was given a diagnosis of aortic dissection based on computed tomography (CT) findings. Two days later the dissection reached the origin of the celiac artery and there was poor blood flow from the body to the tail of the pancreas and fundus of the stomach wall. Severe acute pancreatitis developed. Endoscopy showed a near-circumferential gastric ulcer in the gastric cardia and we diagnosed ischemic gastropathy. A fistula between the area of infected pancreatic necrosis and the stomach had formed spontaneously and the necrotic tissue was draining into the stomach. His recovery was uneventful.

摘要

一名49岁男性因胸痛就诊，根据计算机断层扫描（CT）结果被诊断为主动脉夹层。两天后，夹层累及腹腔干动脉起始部，导致从胰体至胰尾以及胃壁底部的血流减少。继而发展为严重的急性胰腺炎。内镜检查显示贲门处有一个近乎环形的胃溃疡，诊断为缺血性胃病。感染性胰腺坏死区域与胃之间自发形成了瘘管，坏死组织排入胃内。患者康复过程顺利。