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超声诊断胰腺源性糖尿病漏诊病例

Missed Case of Pancreatogenic Diabetes Diagnosed Using Ultrasound.

作者信息

Chakravarthy M Deyananda, Thangaraj Prabha, Saraswathi S

机构信息

Department of Radiology, Trichy SRM Medical College Hospital and Research Centre, Trichy, Tamil Nadu, India.

Department of Community Medicine, Trichy SRM Medical College Hospital and Research Centre, Trichy, Tamil Nadu, India.

出版信息

J Med Ultrasound. 2021 Jan 9;29(3):218-220. doi: 10.4103/JMU.JMU_138_20. eCollection 2021 Jul-Sep.

DOI:10.4103/JMU.JMU_138_20
PMID:34729335
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8515633/
Abstract

Nonalcoholic pancreatogenic diabetes mellitus (type 3c DM) is an often-misdiagnosed entity usually seen in young men of tropical countries. Although most of the patients present with abdominal pain and symptoms of exocrine pancreatic insufficiency, there is still a subset that does not present with these classical symptoms, which emphasizes the need for special diagnostic considerations. The significance of identifying this subset of diabetic lies not only in the change in management of the disease but also in early detection for pancreatic carcinoma that is more common among those patients. In our case, ultrasound with X-ray played a vital role in diagnosis, prompting us to consider it as an essential part of the investigation panel in all newly diagnosed nonobese diabetic individuals.

摘要

非酒精性胰腺源性糖尿病(3c型糖尿病)是一种常被误诊的疾病,常见于热带国家的年轻男性。尽管大多数患者表现为腹痛和外分泌性胰腺功能不全的症状,但仍有一部分患者没有这些典型症状,这凸显了进行特殊诊断考量的必要性。识别这一亚组糖尿病患者的意义不仅在于疾病管理方式的改变,还在于早期发现胰腺癌,胰腺癌在这些患者中更为常见。在我们的病例中,超声检查结合X线检查在诊断中发挥了关键作用,促使我们将其视为所有新诊断的非肥胖糖尿病个体检查项目的重要组成部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/914b/8515633/523ecc6a4c2e/JMU-29-218-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/914b/8515633/1c25f4c691cd/JMU-29-218-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/914b/8515633/ae7d44294d61/JMU-29-218-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/914b/8515633/251d46c74313/JMU-29-218-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/914b/8515633/523ecc6a4c2e/JMU-29-218-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/914b/8515633/1c25f4c691cd/JMU-29-218-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/914b/8515633/ae7d44294d61/JMU-29-218-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/914b/8515633/251d46c74313/JMU-29-218-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/914b/8515633/523ecc6a4c2e/JMU-29-218-g004.jpg

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本文引用的文献

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Imaging in chronic pancreatitis: State of the art review.慢性胰腺炎的影像学检查:最新综述
Indian J Radiol Imaging. 2019 Apr-Jun;29(2):201-210. doi: 10.4103/ijri.IJRI_484_18.
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Chronic Pancreatitis: Current Status and Challenges for Prevention and Treatment.慢性胰腺炎:预防与治疗的现状及挑战
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Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer.继发于慢性胰腺炎和胰腺癌的 3c 型(胰源性)糖尿病。
Lancet Gastroenterol Hepatol. 2016 Nov;1(3):226-237. doi: 10.1016/S2468-1253(16)30106-6. Epub 2016 Oct 12.
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Diagnostic performance of imaging modalities in chronic pancreatitis: a systematic review and meta-analysis.成像模态在慢性胰腺炎中的诊断性能:一项系统评价和荟萃分析。
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Diagnosis and classification of diabetes mellitus.糖尿病的诊断与分类
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Diagnosis and treatment of diabetes mellitus in chronic pancreatitis.慢性胰腺炎糖尿病的诊断与治疗。
World J Gastroenterol. 2013 Nov 14;19(42):7276-81. doi: 10.3748/wjg.v19.i42.7276.
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Pancreatic carcinoma in fibrocalcific pancreatic diabetes: An eastern India perspective.纤维钙化性胰腺糖尿病中的胰腺癌:来自印度东部的观点。
Indian J Endocrinol Metab. 2012 Dec;16(Suppl 2):S486-8. doi: 10.4103/2230-8210.104140.
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Diabetes mellitus secondary to pancreatic diseases (Type 3c)--are we neglecting an important disease?继发于胰腺疾病的糖尿病(3c 型)——我们是否忽视了一种重要的疾病?
Eur J Intern Med. 2013 Apr;24(3):203-6. doi: 10.1016/j.ejim.2012.12.017. Epub 2013 Feb 1.
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Is pancreatic diabetes (type 3c diabetes) underdiagnosed and misdiagnosed?胰腺性糖尿病(3c型糖尿病)是否存在诊断不足和误诊的情况?
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