Skaff Yara, Jarrah Mohammad, Filippaios Andreas, Sharkawi Musa A, Mehawej Jordy
Division of Internal Medicine, Department of Medicine, Lebanese American University Medical Center Rizk Hospital, Beirut, Lebanon.
Department of Medicine, University of Massachusetts Chan Medical School, MA, USA.
Respir Med Case Rep. 2023 Jan 16;42:101813. doi: 10.1016/j.rmcr.2023.101813. eCollection 2023.
Emphysematous pancreatitis is a severe systemic inflammatory process with reports of pulmonary embolism in the setting of acute pancreatitis rarely described.
A 61-year-old woman presented with severe abdominal pain of 1 day duration. She was found to have acute interstitial pancreatitis. During her hospitalization, the patient developed worsening abdominal pain associated with increasing oxygen demands, requiring supplemental oxygen through nasal cannula. Workup showed pulmonary embolism in the posterior segmental branch of the left lower lobar artery and development of emphysematous pancreatitis was noted on imaging. The patient was started on intravenous antibiotics and therapeutic anticoagulation; her condition improved and was discharged home.
Patients with severe acute pancreatitis may be at risk for pulmonary embolism due to immobilization and other inflammatory mechanisms. Mitigating individualized risk factors and anticoagulation use as prophylaxis should be considered in patients with pancreatitis to prevent embolism. Early detection by clinicians is critical to reduce misdiagnosis and mortality rates.
气肿性胰腺炎是一种严重的全身性炎症过程，急性胰腺炎合并肺栓塞的报道很少见。
一名61岁女性，出现持续1天的严重腹痛。她被诊断为急性间质性胰腺炎。住院期间，患者腹痛加重，同时氧需求增加，需要通过鼻导管吸氧。检查发现左下叶动脉后段分支有肺栓塞，影像学检查显示气肿性胰腺炎。患者开始接受静脉抗生素治疗和抗凝治疗；病情好转后出院。
重症急性胰腺炎患者可能因制动及其他炎症机制而有发生肺栓塞的风险。对于胰腺炎患者，应考虑减轻个体化危险因素并使用抗凝剂进行预防以防止栓塞。临床医生的早期检测对于减少误诊和死亡率至关重要。
