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在一名危重症患者中使用经食管和经胃床旁超声诊断肺脓肿和胰腺积液

Diagnosis of Lung Abscess and Pancreatic Collection Using Transesophageal and Transgastric Point-of-Care Ultrasound in a Critically Ill Patient.

作者信息

Cheong Issac

机构信息

Department of Critical Care Medicine, Sanatorio de Los Arcos, Buenos Aires, Argentina.

Argentinian Critical Care Ultrasonography Association (ASARUC), Buenos Aires, Argentina.

出版信息

J Clin Ultrasound. 2025 Feb;53(2):373-376. doi: 10.1002/jcu.23856. Epub 2024 Oct 10.

Abstract

Effectively managing critically ill septic patients requires careful utilization of imaging techniques. While point-of-care ultrasound (POCUS) is invaluable in the ICU, it faces challenges with conventional transcutaneous ultrasound, especially in obese patients. A 22-year-old obese female presented with abdominal pain and renal dysfunction. Abdominal CT confirmed acute biliary pancreatitis, progressing to respiratory failure. Transesophageal and transgastric ultrasound revealed a pulmonary abscess and peripancreatic collection. Expectant management of the lung abscess and percutaneous drainage of the pancreatic collection led to successful recovery. This case highlights POCUS's pivotal role in timely diagnosis, particularly in severe pancreatitis, showcasing its versatility in critical care.

摘要

有效管理重症脓毒症患者需要谨慎运用成像技术。虽然床旁超声(POCUS)在重症监护病房(ICU)中非常宝贵,但它在传统经皮超声方面面临挑战,尤其是在肥胖患者中。一名22岁肥胖女性出现腹痛和肾功能不全。腹部CT证实为急性胆源性胰腺炎,并进展为呼吸衰竭。经食管和经胃超声显示有肺脓肿和胰腺周围积液。对肺脓肿采取期待治疗,对胰腺积液进行经皮引流,最终成功康复。该病例突出了POCUS在及时诊断中的关键作用,特别是在重症胰腺炎中,展示了其在重症监护中的多功能性。

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