Abi-Saleh Simon P, Miller Ethan A, Magge Anil, Perez Mario
Internal Medicine, University of Connecticut School of Medicine, Farmington, USA.
Neurology, University of Connecticut School of Medicine, Farmington, USA.
Cureus. 2022 Mar 17;14(3):e23267. doi: 10.7759/cureus.23267. eCollection 2022 Mar.
Necrotizing pancreatitis is an inflammatory process that poses a strong risk of systemic venous thromboembolism. However, it is often challenging to opt for systemic anticoagulation since the disease is also associated with an increased risk of hemorrhage. Given these opposing complications, a risk versus benefit analysis has to be employed in the management of necrotizing pancreatitis on a case-by-case basis. We discuss a case where the team was faced with a dilemma regarding anticoagulation in a patient with newly developed atrial fibrillation in the setting of necrotizing pancreatitis. We found that there is a lack of guidelines that address the time of initiation and the type of systemic anticoagulation that should be administered in such patients.
坏死性胰腺炎是一种炎症过程，具有发生全身性静脉血栓栓塞的高风险。然而，选择全身性抗凝治疗往往具有挑战性，因为该疾病也伴有出血风险增加。鉴于这些相反的并发症，在坏死性胰腺炎的管理中必须根据具体情况进行风险与获益分析。我们讨论了一个病例，在该病例中，团队在一名坏死性胰腺炎患者新发房颤的情况下，在抗凝治疗方面面临两难境地。我们发现，缺乏针对此类患者开始全身性抗凝治疗的时间和应给予的全身性抗凝类型的指南。
