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一例罕见的出血性胰腺炎继发胃壁内血肿病例。

A Rare Case of Gastric Intramural Hematoma Secondary to Hemorrhagic Pancreatitis.

作者信息

Almaguer Joey, Murray Dylan, Motamedi Sheedeh, Murray Richard

机构信息

Radiology, Texas Tech University Health Sciences Center, Amarillo, USA.

Surgery, University College Dublin, Dublin, IRL.

出版信息

Cureus. 2023 Sep 11;15(9):e45039. doi: 10.7759/cureus.45039. eCollection 2023 Sep.

Abstract

Gastric intramural hematoma (GIH) is a contained hemorrhage located within the layers that comprise the wall of the stomach. It is a rare condition that has a variety of etiologies. Pancreatitis-induced GIH is an even rarer phenomenon, with only a handful of documented cases in the medical literature. In the current case, a patient presented with chronic abdominal pain for the past two months, with an acute worsening of symptoms. CT imaging confirmed a large, stable GIH with concomitant pancreatitis, likely alcohol-induced. Diagnostic laparoscopy was performed in response to worsening hemodynamic status, which confirmed hemorrhagic pancreatitis as the likely cause of the GIH formation. Jackson-Pratt (JP) drains were placed, and the patient was subsequently discharged. The patient returned one month later with an acute exacerbation of pancreatitis; however, interval improvement of the GIH was observed. The patient was transferred to outpatient care for continued conservative treatment without any further return visits.

摘要

胃壁内血肿(GIH)是一种局限于构成胃壁各层内的出血。它是一种病因多样的罕见病症。胰腺炎诱发的GIH更是罕见现象,医学文献中仅有少数病例记载。在本病例中,一名患者过去两个月一直有慢性腹痛,症状近期急性加重。CT成像证实有一个较大的、稳定的GIH,同时伴有胰腺炎,可能是酒精所致。鉴于血流动力学状态恶化,进行了诊断性腹腔镜检查,证实出血性胰腺炎可能是GIH形成的原因。放置了杰克逊-普拉特(JP)引流管,随后患者出院。患者一个月后因胰腺炎急性加重再次就诊;不过,观察到GIH有阶段性改善。该患者被转为门诊治疗进行持续保守治疗,未再有复诊情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cf9/10494740/e7f81f3c6bdf/cureus-0015-00000045039-i01.jpg

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