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剖宫产术后急性胰腺炎

[Acute pancreatitis after cesarean section].

作者信息

Tóth Krisztina, Császár András, Márton Sándor

机构信息

1 Pécsi Tudományegyetem, Általános Orvostudományi Kar, Aneszteziológiai és Intenzív Terápiás Intézet, Szülészeti Aneszteziológiai Tanszék Pécs Magyarország.

2 Pécsi Tudományegyetem, Általános Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika Pécs Magyarország.

出版信息

Orv Hetil. 2023 Aug 6;164(31):1231-1234. doi: 10.1556/650.2023.32831.

Abstract

The prevalence of acute pancreatitis in pregnancy is low; similarly to the non-pregnant population, the outcome varies from mild to fatal forms. Occurrence of the disease in pregnancy is mostly in the third trimester or the postpartum period. The most common cause of acute pancreatitis is cholelithiasis but hypertriglyceridemia, fatty diet, obesity and alcohol consumption are further predisposing factors. A 27-year-old twin-pregnant woman developed acute severe pain 2 days after a cesarean section. Labor tests showed elevated amylase (1080 U/L) and lipase (2670 U/L) serum levels. For the purpose of pain relief, we inserted an epidural catheter and indicated an abdominal computer tomography examination. The abdominal imaging did not show morphological disorder of the pancreas or cholangial obstruction. We performed conservative therapy, early per os feeding, pain relief and fluid resuscitation. On the postpartum 7. day, the serum pancreas enzyme levels decreased to normal and the patient - with her babies - was discharged home. Though acute pancreatitis is a rare event in pregnancy, we should consider it in cases with acute, typical or non-typical pain. It is challenging to differentiate the disease from the acute syndromes of pregnancy. Orv Hetil. 2023; 164(31): 1231-1234.

摘要

妊娠期急性胰腺炎的患病率较低;与非妊娠人群类似,其病情转归从轻度到致命不等。妊娠期该病大多发生在孕晚期或产后。急性胰腺炎最常见的病因是胆石症,但高甘油三酯血症、高脂饮食、肥胖和饮酒也是进一步的诱发因素。一名27岁的双胎妊娠妇女剖宫产术后2天出现急性剧痛。实验室检查显示血清淀粉酶(1080 U/L)和脂肪酶(2670 U/L)水平升高。为缓解疼痛,我们置入了硬膜外导管并安排了腹部计算机断层扫描检查。腹部影像学检查未显示胰腺形态异常或胆管梗阻。我们进行了保守治疗、早期经口进食、止痛和液体复苏。产后第7天,血清胰腺酶水平降至正常,患者及其婴儿出院回家。尽管急性胰腺炎在妊娠期是罕见事件,但对于出现急性、典型或非典型疼痛的病例我们应予以考虑。将该病与妊娠急性综合征相鉴别具有挑战性。《匈牙利医学周报》。2023年;164(31): 1231 - 1234。

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