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轻度 COVID-19 患者中罕见的胰腺炎表现。

Rare presentation of acute pancreatitis in mild COVID-19.

机构信息

Internal Medicine, Saint Joseph Mercy Ann Arbor Hospital, Ann Arbor, Michigan, USA

Internal Medicine, Saint Joseph Mercy Ann Arbor Hospital, Ann Arbor, Michigan, USA.

出版信息

BMJ Case Rep. 2021 Nov 19;14(11):e246720. doi: 10.1136/bcr-2021-246720.

Abstract

Viral-induced pancreatitis has been well-defined; however, there are limited data regarding COVID-19 and pancreatitis. Most cases are commonly in conjunction with severe COVID-19 as well as lipase elevation. We describe a unique case of mild SARS-CoV-2 infection resulting in acute pancreatitis in the absence of lipase elevation. A 39-year-old patient with no medical history, presented with epigastric pain. Vital signs were unremarkable. Patient was positive for COVID-19. Liver function panel, calcium, triglyceride and lipase levels were all unremarkable. CT of the abdomen demonstrated acute pancreatitis without gallstones. Our case may indicate that pancreatic injury in SARS-CoV-2 infection is due to a direct impact on the pancreas by the virus, given the absence of lipase elevation and mild presentation. This case highlights the importance of suspecting pancreatitis in mild COVID-19 that present with atypical symptoms such as epigastric pain, even without lipase elevation.

摘要

病毒引起的胰腺炎已有明确的定义;然而,关于 COVID-19 和胰腺炎的数据有限。大多数病例通常与严重的 COVID-19 以及脂肪酶升高有关。我们描述了一例独特的轻度 SARS-CoV-2 感染导致急性胰腺炎的病例,该病例脂肪酶没有升高。一名 39 岁的患者无病史,表现为上腹痛。生命体征无异常。患者 COVID-19 检测呈阳性。肝功能、钙、甘油三酯和脂肪酶水平均无异常。腹部 CT 显示急性胰腺炎,无胆结石。我们的病例可能表明,SARS-CoV-2 感染中的胰腺损伤是由于病毒对胰腺的直接影响,因为脂肪酶没有升高且临床表现较轻。该病例强调了在表现为非典型症状(如上腹痛)的轻度 COVID-19 中怀疑胰腺炎的重要性,即使脂肪酶没有升高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bcdc/8606762/494b9cf3df6b/bcr-2021-246720f01.jpg

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