Ameerah Yara, Musmar Basel, Awadghanem Ahmed, Abdo Qusai
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
School of Medicine, An-Najah National University, Nablus, Palestine.
Radiol Case Rep. 2023 Feb 10;18(4):1580-1584. doi: 10.1016/j.radcr.2023.01.049. eCollection 2023 Apr.
Diagnosis and management of autoimmune pancreatitis during pregnancy. Autoimmune pancreatitis is a rare and life-threatening condition with increased maternal and fetal morbidity and mortality. Autoimmune pancreatitis may result in a mass-forming lesion in the pancreas resembling pancreatic cancer; therefore, meticulous and careful investigations must be done to avoid misdiagnosing autoimmune pancreatitis as pancreatic cancer. Since autoimmune pancreatitis improves dramatically to steroid therapy, accurate diagnosis of autoimmune pancreatitis can avoid unnecessary procedures, surgeries, and pancreatic resection. A case of a pregnant lady in her third trimester was presented with abdominal pain, nausea, and vomiting. On examination, there was tenderness in both epigastric and right hypochondrium associated with elevated serum amylase, liver transaminases, alkaline phosphatase, gamma-glutamyl transpeptidase, and immunoglobulin G4. Both abdominal ultrasound and magnetic resonance cholangiopancreatography showed a pancreatic head lesion with dilation in both pancreatic duct and common bile duct. Steroid was initiated that resulted in rapid and dramatic responsiveness. Acute pancreatitis is uncommon during pregnancy, and autoimmune pancreatitis is a very rare form of acute pancreatitis; therefore, a clear and rapid assessment, diagnosis, and management plan are necessary to avoid maternal and fetal morbidity and mortality.
妊娠期自身免疫性胰腺炎的诊断与管理。自身免疫性胰腺炎是一种罕见且危及生命的疾病，会增加孕产妇和胎儿的发病率及死亡率。自身免疫性胰腺炎可能导致胰腺出现类似胰腺癌的肿块形成病变；因此，必须进行细致且谨慎的检查，以避免将自身免疫性胰腺炎误诊为胰腺癌。由于自身免疫性胰腺炎对类固醇治疗反应显著，准确诊断自身免疫性胰腺炎可避免不必要的检查、手术及胰腺切除。本文介绍了一例孕晚期孕妇，出现腹痛、恶心和呕吐症状。检查发现上腹部和右季肋部有压痛，同时伴有血清淀粉酶、肝转氨酶、碱性磷酸酶、γ-谷氨酰转肽酶及免疫球蛋白G4升高。腹部超声和磁共振胰胆管造影均显示胰头病变，伴有胰管和胆总管扩张。开始使用类固醇治疗后，患者迅速出现显著反应。急性胰腺炎在妊娠期并不常见，而自身免疫性胰腺炎是急性胰腺炎中非常罕见的一种形式；因此，需要清晰、快速的评估、诊断及管理计划，以避免孕产妇和胎儿的发病及死亡。
