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坏死性筋膜炎:急性坏死性胰腺炎的一种罕见并发症。

Necrotizing Fasciitis: A Rare Complication of Acute Necrotizing Pancreatitis.

作者信息

Kaistha Sumesh, Kumar Ameet, Ramakrishnan T S

机构信息

Assistant Professor, Department of Surgery, Command Hospital Air force, Bangalore, Karnataka, India.

Professor, Department of Surgery, Command Hospital Air force, Bangalore, Karnataka, India.

出版信息

J Clin Diagn Res. 2017 Jun;11(6):PD05-PD06. doi: 10.7860/JCDR/2017/27032.10032. Epub 2017 Jun 1.

Abstract

Necrotizing pancreatitis occurs in 10 to 25% of patients requiring hospital admission for acute pancreatitis and carries a high mortality rate. Necrotizing pancreatitis can cause a spectrum of complications. However, we report an extremely rare complication of necrotizing pancreatitis: necrotizing fasciitis of the abdominal wall. A 56-year-old male patient presented to our center with discoloration of skin over left flank of 15 days duration and pus discharge from it since three days. Two months back he was managed at a private hospital as a case of acute necrotizing pancreatitis and was discharged after one week of inpatient treatment. After discharge patient continued to have malaise and weakness but was able to do his routine day to day activity. On presentation at our hospital, patient was in septic shock and was taken emergently to operating theatre for debridement. However, later, the patient succumbed to his illness. Necrotizing fasciitis is an extremely uncommon complication of necrotizing pancreatitis and has a fulminant course. Timely detection and debridement can avert a potential mortality.

摘要

坏死性胰腺炎发生于10%至25%因急性胰腺炎需住院治疗的患者中,死亡率很高。坏死性胰腺炎可引发一系列并发症。然而,我们报告了一种坏死性胰腺炎极其罕见的并发症:腹壁坏死性筋膜炎。一名56岁男性患者因左侧胁腹皮肤变色15天、且自3天前开始有脓性分泌物而前来我院就诊。两个月前,他在一家私立医院被诊断为急性坏死性胰腺炎并接受治疗,住院一周后出院。出院后患者持续感到不适和虚弱,但仍能进行日常活动。在我院就诊时,患者处于感染性休克状态,被紧急送往手术室进行清创。然而,患者最终因病死亡。坏死性筋膜炎是坏死性胰腺炎极其罕见的并发症,病情凶险。及时发现并进行清创可避免潜在的死亡。

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本文引用的文献

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Necrotizing fasciitis: current concepts and review of the literature.坏死性筋膜炎:当前概念及文献综述
J Am Coll Surg. 2009 Feb;208(2):279-88. doi: 10.1016/j.jamcollsurg.2008.10.032. Epub 2008 Dec 12.
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Early diagnosis of retroperitoneal necrotizing fasciitis.腹膜后坏死性筋膜炎的早期诊断
Crit Care Med. 2001 May;29(5):1071-3. doi: 10.1097/00003246-200105000-00040.
6
Acute necrotizing pancreatitis.急性坏死性胰腺炎
N Engl J Med. 1999 May 6;340(18):1412-7. doi: 10.1056/NEJM199905063401807.
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Necrotizing pancreatitis: operating for life.坏死性胰腺炎:为挽救生命而手术。
World J Surg. 1994 Nov-Dec;18(6):906-10; discussion 910-1. doi: 10.1007/BF00299103.
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Retroperitoneal necrotizing fasciitis.腹膜后坏死性筋膜炎
Br J Surg. 1992 Apr;79(4):342-4. doi: 10.1002/bjs.1800790421.

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