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以新冠病毒感染为潜在病因的急性复杂性胰腺炎

Acute Complicated Pancreatitis With COVID-19 Infection as a Potential Cause.

作者信息

Mansour Subhi, Hallon Kenan, Abramov Roi, Damouny Mira, Rufeizen Liel, Marjiyeh Rozan, Kluger Yoram, Khuri Safi

机构信息

General Surgery Department, Rambam Health Care Campus, Haifa, Israel.

HPB and Surgical Oncology Unit, Rambam Health Care Campus, Haifa, Israel.

出版信息

J Med Cases. 2021 Nov;12(11):429-432. doi: 10.14740/jmc3766. Epub 2021 Nov 5.

DOI:10.14740/jmc3766
PMID:34804300
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8577607/
Abstract

The pandemic coronavirus disease 2019 (COVID-19), an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a significant and dramatic worldwide increase in morbidity and mortality rates throughout the year 2020. Although most patients present with respiratory symptoms such as cough, fever and shortness of breath, gastrointestinal symptoms have increasingly been reported and recognized as a major element of patients' presentation. It was found that angiotensin-converting enzyme 2 receptors (the entry receptors for SARS-CoV-2) are expressed in the pancreas in addition to the lungs, kidneys and the rest of the gastrointestinal tract, which raises the hypothesis that COVID-19 can stand as an etiology for acute pancreatitis in certain circumstances. Herein, we present a case of a COVID-19 patient who presented to the emergency room with clinical, laboratory and radiological findings of acute pancreatitis several days after being diagnosed with COVID-19 infection. He was admitted and treated conservatively. Several weeks following the initial episode, the patient developed a huge pancreatic pseudocyst, which was treated successfully with endoscopic cyst-gastrostomy. To the best of our knowledge, following a meticulous review of the current English literature, this is the second case of pancreatic pseudocyst development following acute pancreatitis due to COVID-19 infection.

摘要

2019年大流行性冠状病毒病(COVID-19)是由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的一种传染病,在2020年全年导致全球发病率和死亡率显著大幅上升。尽管大多数患者表现出咳嗽、发热和呼吸急促等呼吸道症状,但胃肠道症状的报告日益增多,并被确认为患者临床表现的一个主要因素。研究发现,血管紧张素转换酶2受体(SARS-CoV-2的进入受体)除了在肺、肾和胃肠道其他部位表达外,在胰腺中也有表达,这就提出了一个假设,即在某些情况下,COVID-19可能是急性胰腺炎的病因。在此,我们报告一例COVID-19患者,该患者在被诊断为COVID-19感染几天后因急性胰腺炎的临床、实验室和影像学表现就诊于急诊室。他入院后接受了保守治疗。在初次发病几周后,患者出现了一个巨大的胰腺假性囊肿,通过内镜下囊肿胃造口术成功治疗。据我们所知,在对当前英文文献进行细致回顾后,这是第二例因COVID-19感染导致急性胰腺炎后发生胰腺假性囊肿的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/8577607/be0211e903ca/jmc-12-429-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/8577607/cbdba5572351/jmc-12-429-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/8577607/5eee525f7670/jmc-12-429-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/8577607/5c7ab9372c83/jmc-12-429-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/8577607/ece67ca8d6fa/jmc-12-429-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/8577607/be0211e903ca/jmc-12-429-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/8577607/cbdba5572351/jmc-12-429-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/8577607/5eee525f7670/jmc-12-429-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/8577607/5c7ab9372c83/jmc-12-429-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/8577607/ece67ca8d6fa/jmc-12-429-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/8577607/be0211e903ca/jmc-12-429-g005.jpg

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本文引用的文献

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Ann Hepatobiliary Pancreat Surg. 2020 Nov 30;24(4):539-541. doi: 10.14701/ahbps.2020.24.4.539.
2
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Braz J Infect Dis. 2020 Nov-Dec;24(6):561-564. doi: 10.1016/j.bjid.2020.08.011. Epub 2020 Sep 15.
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Coronavirus disease-19 (COVID-19) associated with acute necrotising pancreatitis (ANP).新型冠状病毒肺炎(COVID-19)与急性坏死性胰腺炎(ANP)相关。
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Prevalence, Risk Factors, and Outcomes of Hospitalized Patients With Coronavirus Disease 2019 Presenting as Acute Pancreatitis.2019冠状病毒病以急性胰腺炎为表现的住院患者的患病率、危险因素及预后
Gastroenterology. 2020 Dec;159(6):2226-2228.e2. doi: 10.1053/j.gastro.2020.08.044. Epub 2020 Aug 26.
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COVID-19 Induced Acute Pancreatitis: A Case Report and Literature Review.新型冠状病毒肺炎诱发的急性胰腺炎:一例报告及文献综述
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SARS-CoV2 RNA detection in a pancreatic pseudocyst sample.在胰腺假性囊肿样本中检测到 SARS-CoV2 RNA。
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