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伴有大量出血和多器官功能衰竭的快速进展性气肿性胰腺炎:COVID-19的一种严重后遗症。

Rapidly Progressive Emphysematous Pancreatitis With Massive Hemorrhage and Multi-Organ Failure: A Severe Sequela of COVID-19.

作者信息

Bassi Raghav, Alzghoul Hamza, Charles Kipson, Ruiz de Villa Ariel, Russell Charles R, Okonoboh Peters

机构信息

Internal Medicine, University of Central Florida College of Medicine, Graduate Medical Education/North Florida Regional Medical Center, Gainesville, USA.

Internal Medicine, HCA Florida North Florida Hospital, Gainesville, USA.

出版信息

Cureus. 2023 Jan 12;15(1):e33717. doi: 10.7759/cureus.33717. eCollection 2023 Jan.

Abstract

The COVID-19 global pandemic continues to wreak havoc on a number of affected patients and poses a significant burden on the healthcare system. Even though it has been over two years since the pandemic emerged, clinical presentations in affected patients continue to appall clinicians. Emphysematous pancreatitis is a rare, fatal complication of acute necrotizing pancreatitis presenting with a high mortality rate. This rare entity stems from superinfection of acute necrotizing pancreatitis with gram-negative bacteria, most commonly from ( among others. Herein, we present a rare case of acute necrotizing pancreatitis complicated by emphysematous necrosis with hemorrhagic conversion and septicemia in a 60-year-old morbidly obese male patient without any underlying risk factors. He presented with respiratory failure in the setting of COVID-19 and was subsequently diagnosed with acute necrotizing pancreatitis complicated by emphysematous necrosis. To our knowledge, emphysematous pancreatitis in the setting of COVID-19 with no other attributable causes for pancreatitis was not previously reported in the literature. This article aims to report an unusual association between COVID-19 infection and acute emphysematous pancreatitis with evidence of hemorrhagic conversion. Furthermore, given the neoteric nature of this viral infection, we hope to promote sensitivity toward capturing additional clinical features associated with active COVID-19 infection, with the goal to keep clinicians abreast with its many possible sequelae.

摘要

新型冠状病毒肺炎(COVID-19)全球大流行继续对众多受影响患者造成严重破坏,并给医疗系统带来巨大负担。尽管大流行已出现两年多,但受影响患者的临床表现仍令临床医生震惊。气肿性胰腺炎是急性坏死性胰腺炎的一种罕见致命并发症,死亡率很高。这种罕见情况源于急性坏死性胰腺炎被革兰氏阴性菌超级感染,最常见的是 (等等)。在此,我们报告一例60岁病态肥胖男性患者,无任何潜在危险因素,发生急性坏死性胰腺炎并发气肿性坏死伴出血性转化和败血症。他在COVID-19背景下出现呼吸衰竭,随后被诊断为急性坏死性胰腺炎并发气肿性坏死。据我们所知,文献中此前未报道过在无其他胰腺炎归因原因的COVID-19背景下发生气肿性胰腺炎。本文旨在报告COVID-19感染与伴有出血性转化证据的急性气肿性胰腺炎之间的一种不寻常关联。此外,鉴于这种病毒感染的新颖性,我们希望提高对捕捉与活动性COVID-19感染相关的其他临床特征的敏感性,目标是让临床医生了解其许多可能的后遗症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4159/9922199/85d8d54873d8/cureus-0015-00000033717-i01.jpg

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