Sodoma Andrej M, Stone Eric, Schmitt Andrea, Pellegrini James R, Singh Jaspreet
Internal Medicine, South Shore University Hospital, Bay Shore, USA.
Internal Medicine, Rocky Vista University College of Osteopathic Medicine, Englewood, USA.
Cureus. 2024 Sep 27;16(9):e70339. doi: 10.7759/cureus.70339. eCollection 2024 Sep.
Hemorrhagic pancreatitis is a rare cause of hypovolemic shock. It presents as silent bleeding, with signs of hypovolemic shock and abdominal pain eventually culminating in life-threatening bleeding. This case study delves into a case of hemorrhagic pancreatitis in a 49-year-old male. Notably, he has a history of recurrent lower extremity (LE) deep vein thrombosis (DVT) and atrial fibrillation (AF) on Coumadin. He came in with shortness of breath (SOB) and was admitted for acute hypoxic respiratory failure secondary to Influenza A. A few days into admission, the patient developed acute cardiogenic shock, septic shock, and acute respiratory distress syndrome (ARDS). The patient developed rectal bleeding with a decrease in hemoglobin and hematocrit. A computed tomography (CT) of the chest, abdomen, and pelvis (CAP) without (w/o) contrast was performed to find a source. It showed hemorrhagic pancreatitis in the head/tail region. The bleeding resolved on its own without interventions or blood transfusion. Hemorrhagic pancreatitis carries a high mortality rate. In this case, it had an insidious onset with self-resolution, a rare case. Physicians should make quick referrals for surgical resection in hopes of better outcomes.
出血性胰腺炎是低血容量性休克的罕见病因。其表现为隐匿性出血，伴有低血容量性休克体征和腹痛，最终发展为危及生命的出血。本病例研究深入探讨了一名49岁男性的出血性胰腺炎病例。值得注意的是，他有复发性下肢深静脉血栓形成（DVT）病史，且因服用华法林患有心房颤动（AF）。他因气短入院，因甲型流感继发急性低氧性呼吸衰竭而住院。入院几天后，患者出现急性心源性休克、感染性休克和急性呼吸窘迫综合征（ARDS）。患者出现直肠出血，血红蛋白和血细胞比容下降。进行了胸部、腹部和骨盆（CAP）的非增强计算机断层扫描（CT）以寻找病因。结果显示胰头/胰尾区域有出血性胰腺炎。出血自行缓解，未进行干预或输血。出血性胰腺炎死亡率很高。在本病例中，其起病隐匿且自行缓解，实属罕见。医生应尽快进行手术切除转诊，以期获得更好的治疗效果。
