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以肝脓肿和胰腺炎为首发表现的隐匿性结肠癌 1 例报告

Occult colon cancer with liver abscess and pancreatitis as the first manifestations: A case report.

机构信息

Department of Gastroenterology, Affiliated Hospital of Guizhou Medical University, Guiyang, People's Republic of China.

出版信息

Medicine (Baltimore). 2023 Jan 20;102(3):e32654. doi: 10.1097/MD.0000000000032654.

Abstract

INTRODUCTION

Klebsiella pneumoniae-induced liver abscess (KP-PLA) is a common type of pyogenic liver abscess, severe acute pancreatitis (SAP) has high mortality, and poor prognosis in advanced colon cancer. There have been no report of SAP complicated with colon cancer after KP-PLA as so far. In this study, we reported a case of SAP secondary to KP-PLA with colon cancer for the first time, so as to provide reference for clinical diagnosis and treatment of these diseases.

PATIENT CONCERNS AND DIAGNOSIS

A 64-year-old woman with a history of diabetes visited our hospital with abdominal pain for 5 + days. He was diagnosed with KP-PLA a month ago, which had not healed when he was admitted. He was diagnosed with SAP, and histological examination of colonic biopsy confirmed the diagnosis of moderately differentiated adenocarcinoma.

INTERVENTIONS AND OUTCOMES

He was treated with intravenous antibiotics and underwent modified endoscopic mucosal resection under colonoscopy. We conducted a 2-month follow-up, and there was no recurrence of liver abscess and pancreatitis.

CONCLUSION

Screening for intestinal tumors is necessary in patients with cryptogenic liver abscess, especially KP-PLA with diabetes.

摘要

简介

肺炎克雷伯菌引起的肝脓肿(KP-PLA)是一种常见的化脓性肝脓肿,重症急性胰腺炎(SAP)死亡率高,晚期结肠癌预后差。迄今为止,还没有肺炎克雷伯菌引起的肝脓肿后并发 SAP 合并结肠癌的报道。本研究首次报道了一例 SAP 继发于 KP-PLA 合并结肠癌的病例,为这些疾病的临床诊断和治疗提供了参考。

患者关注和诊断

一名 64 岁女性,有糖尿病病史,因腹痛就诊 5+天。一个月前他被诊断为 KP-PLA,入院时尚未痊愈。他被诊断为 SAP,结肠活检的组织学检查证实了中分化腺癌的诊断。

干预措施和结果

他接受了静脉抗生素治疗,并在内镜下进行了改良内镜黏膜切除术。我们进行了为期 2 个月的随访,肝脓肿和胰腺炎均无复发。

结论

对于隐源性肝脓肿患者,尤其是伴有糖尿病的肺炎克雷伯菌引起的肝脓肿患者,有必要进行肠道肿瘤筛查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9965/9857361/fb4fe9f39c6d/medi-102-e32654-g001.jpg

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