Murthi Mukunthan, Abusalim Abdulrahman, Haque Zohaib, Acob Christine
Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA.
Cureus. 2021 Oct 17;13(10):e18839. doi: 10.7759/cureus.18839. eCollection 2021 Oct.
Pancreatic pseudocyst from pancreatic duct leak is one of the common complications of both acute and chronic pancreatitis. The presentation of such leaks can range from patients being completely asymptomatic to septic shock. Extra-abdominal collections of fluid due to pancreatic duct leaks are very rare. We describe a diagnostically challenging patient with acute chronic pancreatitis presenting with lower extremity swelling and pain, who was found to have a pancreatic fluid leak into the right iliopsoas, right gluteal, and thigh muscle compartment. Despite endoscopic stenting of the pancreatic duct and multiple percutaneous drain placement and antibiotic treatment for abscess formation, the patient's condition deteriorated clinically. Surgical options could not be pursued due to poor functional status.
胰管渗漏导致的胰腺假性囊肿是急慢性胰腺炎的常见并发症之一。此类渗漏的表现范围很广,从患者完全无症状到发生感染性休克。胰管渗漏导致的腹腔外积液非常罕见。我们描述了一名诊断颇具挑战性的急慢性胰腺炎患者,其表现为下肢肿胀和疼痛,经检查发现有胰液渗漏至右髂腰肌、右臀肌和大腿肌间隙。尽管对胰管进行了内镜支架置入、多次经皮置管引流以及针对脓肿形成进行了抗生素治疗,但患者的临床状况仍恶化。由于功能状态不佳,无法采取手术治疗方案。