Heller Matthew T, Hattoum Alexander
Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop Street, Suite 3950 PUH S. Tower, Pittsburgh, PA 15213, USA.
Emerg Radiol. 2012 Dec;19(6):527-33. doi: 10.1007/s10140-012-1054-z. Epub 2012 May 29.
For patients with diabetes, insulin therapy can be an effective treatment for years. However, many diabetics eventually develop complications from the disease, including neuropathy, amputations, atherosclerosis, and kidney failure. While kidney failure can be managed with dialysis, difficulties with monitoring fluid intake and diet, bone loss, anemia, and venous access can be problematic for the patient. Due to the decreased life expectancy and difficulties of medical management of patients with diabetes and renal failure, combined renal-pancreas transplantation is an increasingly used option available to type 1 diabetics with concurrent renal failure due to refinements of surgical technique and immunosuppressive therapy. Due to the increasing number of kidney-pancreas transplant patients, longer post-transplant survival, and increasing number of hospitals performing the procedure, more transplant patients are having their care increasingly shifted away from the major transplant centers to general community hospitals. In many kidney-pancreas transplants patients who present to the emergency department for suspected transplant dysfunction, imaging plays a critical initial role in their diagnosis and management. Therefore, it has become increasingly important that community and emergency department radiologists be able to recognize the normal imaging appearance of renal-pancreas transplants and to identify acute findings.
对于糖尿病患者而言，胰岛素治疗多年来一直是一种有效的治疗方法。然而，许多糖尿病患者最终会出现该疾病的并发症，包括神经病变、截肢、动脉粥样硬化和肾衰竭。虽然肾衰竭可以通过透析来控制，但对患者来说，监测液体摄入量和饮食、骨质流失、贫血以及静脉通路方面的困难可能会成为问题。由于糖尿病和肾衰竭患者的预期寿命缩短以及医疗管理困难，由于手术技术和免疫抑制疗法的改进，肾胰联合移植越来越多地成为患有并发肾衰竭的1型糖尿病患者的一种选择。由于肾胰移植患者数量不断增加、移植后生存期延长以及进行该手术的医院数量增多，越来越多的移植患者的护理正逐渐从主要的移植中心转向普通社区医院。在许多因疑似移植功能障碍而到急诊科就诊的肾胰移植患者中，影像学在其诊断和管理中起着关键的初始作用。因此，社区和急诊科放射科医生能够识别肾胰移植的正常影像学表现并识别急性病变变得越来越重要。
