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经结肠坏死组织切除术:一种罕用的胰腺清创策略。

Transcolonic Necrosectomy: A Rarely-Used Pancreatic Debridement Strategy.

作者信息

Checketts Thomas Rees, Madhu Ravishankar, Sidhu Suhail, Daugherty Evan, Al-Chalabi Ahmed

机构信息

Department of Internal Medicine, Creighton University Medical Center, Omaha, NE.

Creighton University School of Medicine, Omaha, NE.

出版信息

ACG Case Rep J. 2025 Mar 19;12(3):e01634. doi: 10.14309/crj.0000000000001634. eCollection 2025 Mar.

Abstract

Necrotizing pancreatitis represents a life-threatening sequela of acute pancreatitis in which rapid necrotization of pancreatic and abdominal tissue leads to inflammation and sometimes infection. Treatment includes debridement of necrotic tissue to prevent inflammation from spreading and antibiotics if infected. Areas of necrosis are accessed through percutaneous drainage, surgical debridement, or upper endoscopy. In this study, we present a case of walled-off necrosis debrided through a fistulous connection to the transverse colon. Transcolonic necrosectomy is a seldom used approach, which could provide treatment options for necrotizing pancreatitis in anatomically amenable patients.

摘要

坏死性胰腺炎是急性胰腺炎的一种危及生命的后遗症,其中胰腺和腹部组织的快速坏死会导致炎症,有时还会引发感染。治疗方法包括清除坏死组织以防止炎症扩散,若发生感染则使用抗生素。通过经皮引流、手术清创或上消化道内镜检查来处理坏死区域。在本研究中,我们报告了一例通过与横结肠的瘘管连接进行清创的包裹性坏死病例。经结肠坏死组织切除术是一种很少使用的方法,可为解剖结构合适的坏死性胰腺炎患者提供治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d850/11922422/4a8603da072b/ac9-12-e01634-g001.jpg

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