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在创伤病例中,要做好应对意外情况的准备:一例罕见的创伤后胰腺炎合并沙门氏菌病和小肠结肠炎。

In trauma, expect the unexpected: a rare case of post-traumatic pancreatitis associated with salmonellosis and enterocolitis.

作者信息

Apelt Nadja, Thompson Emily, Brown Erica, Schindel David

机构信息

Department of Pediatric Surgery, Children's Health Children's Medical Center Dallas, Dallas, Texas, USA.

出版信息

BMJ Case Rep. 2018 Nov 8;2018:bcr-2018-226286. doi: 10.1136/bcr-2018-226286.

Abstract

A 16-year-old Hispanic man was transferred to our level I paediatric trauma centre with pancreatitis. Ten days prior, he had sustained a gunshot wound to the abdomen requiring an exploratory laparotomy for repair of a traumatic left diaphragmatic injury. Additional injuries included gastric, renal, liver and pancreatic lacerations as well as a T12 burst fracture that resulted in paraplegia. Conservative management of pancreatitis was unsuccessful over the next 10 days, resulting in progressive symptoms of severe unresolved pain, nausea, emesis and rising lipase. Workup for post-traumatic, biliary and drug-associated causes of pancreatitis was negative, and no anatomical abnormalities were found on imaging. A fever workup on hospital day 10 revealed a urinary tract infection with non-typhoid sp, and subsequent stool and imaging studies revealed salmonellosis associated with right-sided colitis and infection. Pancreatitis resolved within 48 hours following treatment of salmonellosis and .

摘要

一名16岁的西班牙裔男性因胰腺炎被转至我们的一级儿科创伤中心。10天前,他腹部遭受枪伤,需要进行剖腹探查术以修复外伤性左膈肌损伤。其他损伤包括胃、肾、肝和胰腺裂伤以及导致截瘫的T12爆裂骨折。在接下来的10天里,胰腺炎的保守治疗未成功,导致严重未缓解的疼痛、恶心、呕吐和脂肪酶升高的症状逐渐加重。对创伤后、胆汁性和药物相关性胰腺炎病因的检查均为阴性,影像学检查未发现解剖学异常。入院第10天的发热检查发现非伤寒沙门氏菌引起的尿路感染,随后的粪便和影像学检查显示沙门氏菌病与右侧结肠炎和感染有关。沙门氏菌病和(此处原文似乎不完整)治疗后48小时内胰腺炎得到缓解。

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