孤立性化脓性胰腺脓肿一例报道并文献复习

doi:10.12114/j.issn.1007-9572.2019.00.210

中国全科医学 ›› 2019, Vol. 22 ›› Issue (33): 4150-4152.DOI: 10.12114/j.issn.1007-9572.2019.00.210

所属专题：胰腺炎最新文章合集

孤立性化脓性胰腺脓肿一例报道并文献复习

孟雪1，2，郑吉敏1，王玉珍1*

1.050000河北省石家庄市，河北省人民医院消化科
2.075000河北省张家口市，河北北方学院
*通信作者：王玉珍，教授，主任医师；E-mail：yuzhenwang@163.com

出版日期:2019-11-20 发布日期:2019-11-20

Isolated Pyogenic Pancreatic Abscess：a Case Report and Literature Review　

MENG Xue1，2，ZHENG Jimin1，WANG Yuzhen1*

1.Department of Gastroenterology，Hebei General Hospital，Shijiazhuang 050000，China
2.Hebei North University，Zhangjiakou 075000，China
*Corresponding author：WANG Yuzhen，Professor，Chief physician；E-mail：yuzhenwang@163.com

Published:2019-11-20 Online:2019-11-20

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摘要/Abstract

摘要： 孤立性化脓性胰腺脓肿是一种较为罕见的疾病，临床表现为腹痛、发热，伴白细胞计数升高。在有结核病、沙门菌等感染时，尤其在糖尿病患者中发现胰腺肿块时需警惕该病。目前孤立性化脓性胰腺脓肿的病因和发病机制尚不明确。本文报道了1例2018-03-26在河北省人民医院消化科住院发现孤立性化脓性胰腺脓肿患者，并对其临床病例资料及治疗过程进行了回顾性分析，总结出孤立性化脓性胰腺脓肿诊治过程中易误诊为胰头癌或胰腺囊肿，认为需结合腹部增强CT、肿瘤标志物及超声内镜穿刺活检病理特征进一步明确诊断，从而早期诊断及治疗，以免误诊、漏诊。

关键词: 脓肿；胰腺；超声内镜；糖尿病, 2型；病灶感染；诊断

Abstract: Isolated pyogenic pancreatic abscess（IPPA） is a relatively rare disease with clinical manifestations of abdominal pain，fever，and elevated white blood cell（WBC）count.In the case of infections such as tuberculosis and salmonella，especially when it is found in diabetic patients，it is necessary to be alert to IPPA.The etiology and pathogenesis of IPPA are still unclear.This article reported a patient who was diagnosed with IPPA in the Department of Gastroenterology of Hebei General Hospital on March 26，2018.The clinical pathological data and treatment process were retrospectively analyzed.It was found that IPPA was easy to be misdiagnosed as pancreatic head cancer or pancreatic cyst.It was considered that it was necessary to combine the abdominal enhanced computed tomography，tumor markers and pathological features of endoscopic biopsy to further confirm the diagnosis of IPPA，so that it could be early diagnosed and treated avoiding misdiagnosis and missed diagnosis.

Key words: Abscess；Pancreas；Endoscopic ultrasonography；Diabetes mellitus, type 2；Focal infection；Diagnosis

孟雪,郑吉敏,王玉珍. 孤立性化脓性胰腺脓肿一例报道并文献复习[J]. 中国全科医学, 2019, 22(33): 4150-4152. DOI: 10.12114/j.issn.1007-9572.2019.00.210.
MENG Xue,ZHENG Jimin,WANG Yuzhen. Isolated Pyogenic Pancreatic Abscess：a Case Report and Literature Review　[J]. Chinese General Practice, 2019, 22(33): 4150-4152. DOI: 10.12114/j.issn.1007-9572.2019.00.210.

参考文献

［1］周雨迁，崔毅，李初俊，等．36例胰头癌超声内镜诊断分析［J］.中国内镜杂志，2006，12（7）：683-685．DOI：10.3969/j.issn.1007-1989.2006.07.003.
［2］张波，黄铁汉，何剪太，等．胰腺癌及壶腹周围癌的超声内镜声像特征分析［J］.中国内镜杂志，2005，11（5）：460-462.
［3］LIU Q D，HE Z P，BIE P.Solitary pancreatic tuberculous abscess mimicking pancreatic cystadenocarcinoma：a case report［J］.BMC Gastroenterol，2003，3：1．DOI：10.1186/1471-230x-3-1.
［4］ARYA M，ARYA P K.Pancreatic abscess caused by s.typhi［J］.Indian J Med Microbiol，2001，19（2）：18-19.
［5］YI S Y，TAE J H.Pancreatic abscess following scrub typhus associated with multiorgan failure［J］.World J Gastroenterol，2007，13（25）：3523-3525.
［6］ELIASHIV A，OLUMIDE F，NORTON L，et al．Depression of cell-mediated immunity in diabetes［J］.Arch Surg，1978，113（10）：1180-1183.
［7］PELEG A Y，WEERARATHNA T，MCCARTHY J S，et al．Common infections in diabetes：pathogenesis，management and relationship to glycaemic control［J］.Diabetes Metab Res Rev，2007，23（1）：3-13．DOI：10.1002/dmrr.682.
［8］SIEGEL R L，MILLER K D，JEMAL A.Cancer statistics，2018［J］.CA Cancer J Clin，2018，68（1）：7-30．DOI：10.3322/caac.21442.
［9］CHAUDHARY A，NEGI S S，SACHDEV A K，et al．Pancreatic tuberculosis：still a histopathological diagnosis［J］.Dig Surg，2002，19（5）：389-392．DOI：10.1159/000065832.
［10］SUZUKI R，BHUTANI M S，RAMIREDDY S，et al．The diagnostic value of repeat endoscopic ultrasound-guided fine needle aspiration（EUS-FNA） forsolid pancreatic lesions：a tertiary referral center experience ［J］.Gastrointestinal Endoscopy，2012，75（4）：199．DOI：10.1016/j.gie.2012.04.340.
［11］孙瑞，蔡迎彬，李丹萍，等．超声内镜引导下细针穿刺活检联合基因检测对胰腺癌的诊断价值［J］.现代生物医学进展，2016，16（30）：5921-5922，5842．DOI：10.13241/j.cnki.pmb.2016.30.032.
［12］SENOO J，MIKATA R，KISHIMOTO T，et al．Diagnostic value of immunohistochemical IMP3 expression in EUS-FNA of pancreatic solid mass［J］.Pancreatology，2016，16（4）：S74．DOI：10.1016/j.pan.2016.06.267.
［13］黄强，刘臣海，彭斌，等．超声内镜引导下细针穿刺活检（EUS-FNA）在胰腺占位性病变中的诊断价值及安全性评估［J］.肝胆外科杂志，2016，24（3）：175-178.
［14］ELOUBEIDI M A，TAMHANE A.EUS-guided FNA of solid pancreatic masses：a learning curve with 300 consecutive procedures［J］.Gastrointest Endosc，2005，61（6）：700-708.
［15］KHASHAB M A，KIM K，LENNON A M，et al．Should we do EUS/FNA on patients with pancreatic cysts? The incremental diagnostic yield of EUS over CT/MRI for prediction of cystic neoplasms［J］.Pancreas，2013，42（4）：717-721．DOI：10.1097/MPA.0b013e3182883a91.

孤立性化脓性胰腺脓肿一例报道并文献复习

Isolated Pyogenic Pancreatic Abscess：a Case Report and Literature Review

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