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暴饮暴食后失明:急性酒精性胰腺炎中的类Purtscher视网膜病变

Blind After a Binge: Purtscher-like Retinopathy in Acute Alcoholic Pancreatitis.

作者信息

Tariq Tooba, Reaume Michael, Hammar Dagan, Shallal Anita, Schauer Mark

机构信息

Department of Internal Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI.

Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI.

出版信息

ACG Case Rep J. 2019 Nov 28;6(11):e00251. doi: 10.14309/crj.0000000000000251. eCollection 2019 Nov.

Abstract

Purtscher-like retinopathy is an occlusive microvasculopathy that causes sudden onset vision loss of varying severity. The condition is a rare complication of acute pancreatitis and is scarcely documented in the literature. In addition, it is vision-threatening, and there are no evidence-based therapies available. We report a 37-year-old woman presenting with abdominal pain and nausea in the setting of heavy alcohol use. She was diagnosed with acute pancreatitis. During hospitalization, she developed acute visual disturbance and was found to have significantly diminished visual acuity. A dilated funduscopic examination demonstrated multiple retinal cotton wool spots bilaterally and macular edema. The patient was diagnosed with Purtscher-like retinopathy in the setting of acute pancreatitis. Although the prognosis for her vision was guarded, given the ischemic nature of the insult, she had subjective improvement in visual acuity during the remainder of the hospital course with symptomatic management.

摘要

类Purtscher视网膜病变是一种闭塞性微血管病变,可导致突然发作的不同程度视力丧失。这种情况是急性胰腺炎的一种罕见并发症,在文献中鲜有记载。此外,它会威胁视力,且尚无循证疗法。我们报告一名37岁女性,在大量饮酒后出现腹痛和恶心。她被诊断为急性胰腺炎。住院期间,她出现急性视力障碍,视力明显下降。散瞳眼底检查显示双侧有多个视网膜棉絮斑和黄斑水肿。该患者在急性胰腺炎背景下被诊断为类Purtscher视网膜病变。尽管鉴于损伤的缺血性质,她的视力预后不佳,但通过对症治疗,在住院期间视力有主观改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb04/7145208/0be40b3a24eb/ac9-6-e00251-g001.jpg

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