Hayase T, Yamamoto K, Matsumoto H, Abiru H, Yamamoto Y, Ojima K, Matsubayashi K, Fukui Y
Department of Legal Medicine, Kyoto University Faculty of Medicine, Japan.
Nihon Hoigaku Zasshi. 1996 Apr;50(2):87-91.
A fatal case of acute pancreatitis is reported. On account of difficulty in eating caused by persistent dysphagia and heartburn, the clinical condition of a 39-year-old man who had been a heavy drinker deteriorated rapidly. He was taken to a hospital in an ambulance in an unconscious state. Based on the endoscopic examination and blood chemistry data, the diagnosis of hemorrhagic esophagitis and hepatic failure was made. Treatment including fluid infusion was unsuccessful and he died on the second hospital day. Based on a strong suspicion that the pathologic change in the esophagus may have been chemical esophagitis caused by corrosives of some type, the police ordered an administrative autopsy. The postmortem examination revealed marked necrosis in the pancreas and in the abdominal fatty tissue including the omentum and the mesentery. The necrotic areas in the pancreas were accompanied by only a slight degree of hemorrhage. The cause of death was diagnosed as acute pancreatitis. The pathologic change in the esophagus was identified as Candida esophagitis. Alcohol abuse and malnutrition caused by esophagitis were both considered to be factors which lead to the acute fatal pancreatitis.
报告了一例急性胰腺炎致死病例。一名39岁有酗酒史的男性，因持续性吞咽困难和烧心导致进食困难，临床状况迅速恶化。他在昏迷状态下被救护车送往医院。根据内镜检查和血液化学数据，诊断为出血性食管炎和肝衰竭。包括输液在内的治疗未成功，他在住院第二天死亡。基于强烈怀疑食管的病理变化可能是某种腐蚀性物质引起的化学性食管炎，警方下令进行行政尸检。尸检显示胰腺以及包括大网膜和肠系膜在内的腹部脂肪组织有明显坏死。胰腺坏死区域仅伴有轻微出血。死亡原因诊断为急性胰腺炎。食管的病理变化被确定为念珠菌性食管炎。酗酒和食管炎导致的营养不良均被认为是导致急性致命性胰腺炎的因素。
