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急性胰腺炎:结肠镜检查后罕见的后遗症

Acute Pancreatitis: A Rare Post-Colonoscopy Sequela.

作者信息

Nair Sujit P, Debnath Prasanta, Udgirkar Suhas, Junare Parmeshwar, Chandnani Sanjay, Jain Shubham, Pawar Vinay B, Rathi Pravin M

机构信息

Department of Gastroenterology, Topiwala National Medical College and B.Y.L Nair Charitable Hospital, Mumbai, India.

出版信息

Clin Endosc. 2020 Sep;53(5):611-614. doi: 10.5946/ce.2019.151. Epub 2020 Feb 12.

Abstract

Abdominal pain is a common but benign symptom after colonoscopy. We report a case of acute pancreatitis that occurred just after an elective screening colonoscopy; this is a rare event with very few reported cases. A healthy, asymptomatic male underwent screening colonoscopy at our center and developed abdominal pain and emesis after the procedure. An abdominal X-ray ruled out perforation but laboratory tests revealed elevated levels of amylase and lipase. The patient had no etiological risk factors for pancreatitis. The presumed mechanism of pancreatitis in this case is mechanical and pressure trauma from excessive insufflation, external abdominal pressure, and repeated withdrawal of the colonoscope due to tight angulation of the splenic flexure, a structure that is in close proximity to the pancreatic tail. Acute pancreatitis should be considered in the differential diagnosis of patients who present with abdominal pain after colonoscopy once more common etiologies have been excluded.

摘要

腹痛是结肠镜检查后常见的良性症状。我们报告一例在择期筛查结肠镜检查后即刻发生急性胰腺炎的病例;这是一种罕见事件,报道的病例极少。一名健康、无症状男性在我们中心接受了筛查结肠镜检查,术后出现腹痛和呕吐。腹部X线检查排除了穿孔,但实验室检查显示淀粉酶和脂肪酶水平升高。该患者没有胰腺炎的病因学危险因素。本例胰腺炎的推测机制是由于脾曲角度过紧,脾曲与胰尾结构紧密相邻,过度充气、腹部外部压力以及反复回撤结肠镜导致的机械性和压力性创伤。在排除了更常见病因后,对于结肠镜检查后出现腹痛的患者,鉴别诊断时应考虑急性胰腺炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9067/7548147/7b13c1024142/ce-2019-151f1.jpg

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