Neves Zélia, Segura Úrsula, Valente André, Pacheco M Helena, Malhado José
Medicine Department 7.1, Hospital Curry Cabral, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
GE Port J Gastroenterol. 2015 Mar 29;22(3):117-120. doi: 10.1016/j.jpge.2015.01.007. eCollection 2015 May-Jun.
Pancreatic panniculitis is a rare skin disorder that occurs in 2-3% of pancreatic diseases, mostly associated with acute or chronic pancreatitis. Its pathophysiology is still unclear, but the release of pancreatic enzymes in circulation can be responsible for this disorder. The typical histological features are adipocyte necrosis with neutrophils infiltrate and typical "ghost cells". Its treatment, clinical course and prognosis are usually related with the pancreatic disease. We present a case of a 39-year-old man who presented with fever, abdominal pain, nausea and vomiting after a copious alcohol ingestion. Acute alcohol-induced pancreatitis was diagnosed. 9 days after admission he developed tender erythematous subcutaneous nodules, whose biopsy was consistent with pancreatic panniculitis. There was clinical and laboratory improvement with supportive treatment as well as skin nodules regression. Although pancreatic panniculitis is a rare condition, physicians must be aware of it to avoid delay in the diagnosis.
胰腺性脂膜炎是一种罕见的皮肤疾病，发生于2%至3%的胰腺疾病患者中，大多与急性或慢性胰腺炎相关。其病理生理学仍不清楚，但循环中胰腺酶的释放可能是导致该疾病的原因。典型的组织学特征是脂肪细胞坏死伴中性粒细胞浸润及典型的“鬼影细胞”。其治疗、临床病程及预后通常与胰腺疾病相关。我们报告一例39岁男性患者，大量饮酒后出现发热、腹痛、恶心和呕吐。诊断为急性酒精性胰腺炎。入院9天后，他出现压痛性红斑皮下结节，活检结果符合胰腺性脂膜炎。经支持治疗后临床及实验室指标改善，皮肤结节消退。尽管胰腺性脂膜炎是一种罕见疾病，但医生必须对此有所认识，以免延误诊断。
