生酮饮食期间复发性急性胰腺炎——病例报告及文献综述
Recurrent acute pancreatitis during a ketogenic diet-a case report and literature review.
作者信息
Choi Joseph, Young Tayler L, Chartier Lucas B
机构信息
Emergency Department, University Health Network, 200 Elizabeth Street, RFE - Ground Floor, 480, Toronto, Ontario, M5G 2C4, Canada.
Division of Emergency Medicine, Department of Medicine, University of Toronto, C. David Naylor Building, 6 Queen's Park Crescent West, Third Floor, Toronto, Ontario, M5S 3H2, Canada.
出版信息
Int J Emerg Med. 2021 Sep 15;14(1):52. doi: 10.1186/s12245-021-00374-5.
BACKGROUND
The ketogenic ("keto") diet has been gaining more attention lately in the medical literature and the lay media as a potentially effective method for weight control and management of type 2 diabetes. Though rare, there have been case reports of serious side effects. Here, we present a peculiar case of pancreatitis presumably associated with the ketogenic diet.
CASE PRESENTATION
A 35-year-old man on a calorie-restricted ketogenic diet presented to the emergency department with weekly abdominal pain on Monday mornings, each time after dietary indiscretions ("cheat days") on the weekend. It was found that he had a clinical presentation consistent with acute pancreatitis with no associated alcohol use, hypertriglyceridemia, pancreatic obstruction, or other anatomic abnormalities. The patient's symptoms resolved with conservative management and progressive reintroduction of a standard diet.
CONCLUSION
This case indicates that the ketogenic diet could lower the threshold for acute pancreatitis, and that an episodic stressor may trigger an acute attack in the absence of traditional risk factors.
背景
生酮饮食最近在医学文献和大众媒体中受到越来越多的关注，被视为一种控制体重和管理2型糖尿病的潜在有效方法。尽管严重副作用的病例报告很少见，但仍有相关报道。在此，我们呈现一例推测与生酮饮食相关的特殊胰腺炎病例。
病例介绍
一名35岁男性，采用热量限制的生酮饮食，每周一早上因腹痛前往急诊科就诊，每次腹痛均发生在周末饮食不节制（“放纵日”）之后。发现他的临床表现符合急性胰腺炎，且无酒精使用、高甘油三酯血症、胰腺梗阻或其他解剖学异常。患者的症状通过保守治疗和逐步重新引入标准饮食得以缓解。
结论
该病例表明，生酮饮食可能会降低急性胰腺炎的发病阈值，并且在没有传统危险因素的情况下，间歇性应激源可能引发急性发作。
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