O'Connor Adam, Asaad Peter
Department of General Surgery, Royal Albert Edward Infirmary, Wigan, UK.
BMJ Case Rep. 2019 Feb 13;12(2):e227438. doi: 10.1136/bcr-2018-227438.
We report a case of a 55-year-old man taxi driver admitted electively for high tibial osteotomy for relief of bilateral medial compartment osteoarthritis. He was obese and an ex-smoker but medical history was otherwise unremarkable. Day 1 postoperatively the patient started to suffer vomiting episodes and the abdomen was distended. C Reactive protein and white cell count were both elevated but other bloods were normal. CT abdomen and pelvis was performed which showed acute interstitial pancreatitis. Glasgow score was calculated as 2. He was treated aggressively with analgesia, intravenous fluid and intravenous antibiotics. He has made a good recovery following these conservative measures. To our knowledge, this is the first case in the literature reporting pancreatitis as a complication of high tibial osteotomy. This case highlights the importance of close monitoring for abdominal complications even in the setting of elective orthopaedic surgery where it is a rare phenomenon.
我们报告了一例55岁男性出租车司机，因双侧内侧间室骨关节炎行高位胫骨截骨术而择期入院。他肥胖且既往吸烟，但其病史无其他显著异常。术后第1天，患者开始出现呕吐发作，腹部膨隆。C反应蛋白和白细胞计数均升高，但其他血液检查结果正常。进行了腹部和骨盆CT检查，显示为急性间质性胰腺炎。计算得出格拉斯哥评分2分。给予其积极的镇痛、静脉补液及静脉抗生素治疗。采取这些保守措施后，他恢复良好。据我们所知，这是文献中首例报道胰腺炎作为高位胫骨截骨术并发症的病例。该病例凸显了即使在择期骨科手术这种罕见现象发生时，密切监测腹部并发症的重要性。
