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自发性脾破裂:克罗恩病患者急性胰腺炎的一种罕见并发症。

Spontaneous splenic rupture: a rare complication of acute pancreatitis in a patient with Crohn's disease.

作者信息

Mujtaba Ghulam, Josmi Joseph, Arya Mukul, Anand Sury

机构信息

Department of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Brooklyn, N.Y., USA.

出版信息

Case Rep Gastroenterol. 2011 Apr 13;5(1):179-82. doi: 10.1159/000327215.

Abstract

Crohn's disease (CD) is an idiopathic inflammatory bowel disease which can involve any part of the gastrointestinal tract. It frequently involves the ileum, colon and the anorectum. Although rare, acute pancreatitis as a complication of CD involving the duodenum has been described in the literature. We describe a 37-year-old male with CD presenting with acute pancreatitis and spontaneous splenic rupture. The potential mechanisms associated with acute pancreatitis along with spontaneous rupture of the spleen in this patient population and its treatment will be discussed. Common complaints such as upper abdominal pain in a patient with CD should undergo workup to exclude less commonly involved sites such as the pancreas and spleen. Close monitoring in the critical care setting is recommended in carefully selected and hemodynamically stable patients with splenic rupture. Surgical treatment is considered as the standard of care in hemodynamically unstable patients.

摘要

克罗恩病(CD)是一种特发性炎症性肠病,可累及胃肠道的任何部位。它常累及回肠、结肠和肛门直肠。虽然罕见,但文献中已描述过累及十二指肠的CD并发急性胰腺炎。我们报告一名37岁患有CD的男性,出现急性胰腺炎和自发性脾破裂。将讨论该患者群体中与急性胰腺炎以及脾自发性破裂相关的潜在机制及其治疗方法。CD患者出现的常见主诉如腹痛,应进行检查以排除较少累及的部位,如胰腺和脾脏。对于精心挑选且血流动力学稳定的脾破裂患者,建议在重症监护环境中密切监测。对于血流动力学不稳定的患者,手术治疗被视为标准治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9302/3088744/c4a3b80f29be/crg0005-0179-f01.jpg

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