Aliotta Roberta, Zanoli Luca, Lauretta Itria, Giunta Rosa, Ferrario Silvia, Rastelli Stefania, Rapisarda Sebastiano, Rahbari Elnaz, Rapisarda Francesco
Section of Nephrology, Department of Clinical and Experimental Medicine, Policlinico Universitario, University of Catania, Catania, Italy.
Clin Med Insights Case Rep. 2018 Mar 26;11:1179547618765761. doi: 10.1177/1179547618765761. eCollection 2018.
Until 2018, 236 cases of acute pancreatitis have been reported in patients who underwent peritoneal dialysis. Here, we presented a patient with double renal transplantation with chronic renal failure, under renal replacement therapy by peritoneal dialysis, who developed acute pancreatitis with abdominal pain, nausea, vomiting, leukocytosis with neutrophil left shift which is complicated by pancreatic pseudocyst, candida peritonitis, fungal sepsis, overlapping of sepsis, and pneumonitis. After the percutaneous cystogastrostomy drainage of pancreatic pseudocyst, changes from peritoneal dialysis to hemodialysis, various thoracentesis, and polyantibiotics therapy, the resolution of the sepsis state was seen. The particular aspect of our case is the various comorbidity risks, severe pancreatitis associated with candida and sepsis, and treatment strategy that lead to heal this kind of the high mortality rate condition.
截至2018年，已有236例接受腹膜透析的患者被报道发生急性胰腺炎。在此，我们报告了一例接受双肾移植的慢性肾衰竭患者，该患者正在接受腹膜透析进行肾脏替代治疗，其发生了急性胰腺炎，伴有腹痛、恶心、呕吐、白细胞增多伴中性粒细胞左移，并并发胰腺假性囊肿、念珠菌性腹膜炎、真菌败血症、败血症重叠及肺炎。在对胰腺假性囊肿进行经皮囊肿胃造瘘引流、从腹膜透析改为血液透析、多次胸腔穿刺及多种抗生素治疗后，败血症状态得到缓解。我们病例的特殊之处在于存在各种合并症风险、与念珠菌和败血症相关的严重胰腺炎，以及治愈这种高死亡率疾病的治疗策略。
