Lin Kyawzaw, Ofori Emmanuel, Lin Aung Naing, Lin Sithu, Lin Thinzar, Rasheed Ameer, Vasudevan Viswanath, Reddy Madhavi
Department of Internal Medicine, The Brooklyn Hospital Center, Affiliate of the Mount Sinai Hospital, Brooklyn, New York, USA.
GI Department, The Brooklyn Hospital Center, Affiliate of the Mount Sinai Hospital, Brooklyn, New York, USA.
Case Rep Gastroenterol. 2018 May 31;12(2):217-223. doi: 10.1159/000489296. eCollection 2018 May-Aug.
Acute pancreatitis (AP) is an inflammatory disease presenting from mild localized inflammation to severe infected necrotic pancreatic tissue. In the literature, there are a few cases of hypothermia-induced AP. However, the association between hypothermia and AP is still a myth. Generally, mortality from acute pancreatitis is nearly 3-6%. Here, we present a 40-year-old chronic alcoholic female who presented with acute pancreatitis induced by transient hypothermia. A 40-year-old chronic alcoholic female was hypothermic at 81°F on arrival which was improved to 91.7°F with warming blanket and then around 97°F in 8 h. Laboratory tests including complete blood count, lipid panel, and comprehensive metabolic panels were within the normal limit. Serum alcohol level was 0.01, amylase 498, lipase 1,200, ammonia 26, serum carboxyhemoglobin level 2.4, and β-HCG was negative. The entire sepsis workup was negative. During rewarming period, she had one episode of witnessed generalized tonic-clonic seizure. It was followed by transient hypotension. Fluid challenge was successful with 2 L of normal saline. Sonogram (abdomen) showed fatty liver and trace ascites. CAT scan (abdomen and pelvis) showed evidence of acute pancreatitis without necrosis, peripancreatic abscess, pancreatic mass, or radiopaque gallstones. The patient was managed medically and later discharged from the hospital on the 4th day as she tolerated a normal low-fat diet. In our patient, transient hypothermia from chronic alcohol abuse and her social circumstances might predispose to microcirculatory disturbance resulting in acute pancreatitis. Early and aggressive fluid resuscitation prevents complications.
急性胰腺炎（AP）是一种炎症性疾病，表现从轻度局部炎症到严重的感染性坏死胰腺组织。在文献中，有几例体温过低诱发急性胰腺炎的病例。然而，体温过低与急性胰腺炎之间的关联仍是个谜。一般来说，急性胰腺炎的死亡率接近3%至6%。在此，我们报告一名40岁的慢性酒精中毒女性，她因短暂体温过低诱发了急性胰腺炎。一名40岁的慢性酒精中毒女性入院时体温为81°F，使用保暖毯后体温升至91.7°F，8小时后约为97°F。包括全血细胞计数、血脂分析和综合代谢指标在内的实验室检查均在正常范围内。血清酒精水平为0.01，淀粉酶498，脂肪酶1200，氨26，血清碳氧血红蛋白水平2.4，β-人绒毛膜促性腺激素为阴性。整个脓毒症检查结果均为阴性。在复温期间，她有一次全身性强直阵挛发作。随后出现短暂性低血压。给予2升生理盐水进行液体冲击治疗成功。超声检查（腹部）显示脂肪肝和少量腹水。计算机断层扫描（腹部和盆腔）显示有急性胰腺炎的迹象，但无坏死、胰周脓肿、胰腺肿块或不透X线的胆结石。患者接受药物治疗，由于能耐受正常低脂饮食，于第4天出院。在我们的患者中，慢性酒精滥用导致的短暂体温过低及其社会环境可能易引发微循环紊乱，从而导致急性胰腺炎。早期积极的液体复苏可预防并发症。
