Dai Mu-Gen, Li Li-Fen, Cheng Hai-Yan, Wang Jian-Bo, Ye Bin, He Fei-Yun
Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China.
Department of Gastroenterology, Liandu District People's Hospital, Lishui 323000, Zhejiang Province, China.
World J Clin Cases. 2022 May 6;10(13):4185-4189. doi: 10.12998/wjcc.v10.i13.4185.
Acute pancreatitis is an uncommon complication of gastrointestinal endoscopy, especially if the patient has none of the common risk factors associated with pancreatitis; such as alcoholism, gallstones, hypertriglyceridemia, hypercalcemia or the use of certain drugs.
A 56-year-old female patient developed abdominal pain immediately after the completion of an upper gastrointestinal endoscopy. The pain was predominantly in the upper and middle abdomen and was persistent and severe. The patient was diagnosed with acute pancreatitis. Treatment included complete fasting, octreotide injection prepared in a prefilled syringe to inhibit pancreatic enzymes secretion, ulinastatin injection to inhibit pancreatic enzymes activity, esomeprazole for gastric acid suppression, fluid replacement and nutritional support. Over the next 3 d, the patient's symptoms improved. The patient remained hemodynamically stable throughout hospitalization and was discharged home in a clinically stable state.
Pancreatitis should be considered in the differential diagnosis of abdominal pain after upper and lower gastrointestinal endoscopy.
急性胰腺炎是胃肠内镜检查中一种不常见的并发症,尤其是当患者没有与胰腺炎相关的常见危险因素时;如酗酒、胆结石、高甘油三酯血症、高钙血症或使用某些药物。
一名56岁女性患者在完成上消化道内镜检查后立即出现腹痛。疼痛主要位于上腹部和中腹部,持续且剧烈。该患者被诊断为急性胰腺炎。治疗包括完全禁食、使用预填充注射器配制的奥曲肽注射液抑制胰酶分泌、乌司他丁注射液抑制胰酶活性、埃索美拉唑抑制胃酸、补液和营养支持。在接下来的3天里,患者的症状有所改善。患者在住院期间血流动力学一直稳定,出院时临床状态稳定。
在上下消化道内镜检查后腹痛的鉴别诊断中应考虑胰腺炎。