自身免疫性胰腺炎二例误诊原因分析并文献复习  

Misdiagnosis Causes and Literature Review of Two Patients with Autoimmune Pancreatitis

作　　者：梅建民[1] 聂洪峰[1] 孙泊洋[1] 巨邦律[1] 

机构地区：[1]北京军区总医院肝胆外科,北京100700

出　　处：《临床误诊误治》2014年第4期17-21,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的提高临床对自身免疫性胰腺炎(autoimmune pancreatitis,AIP)的认识,减少误诊误治。方法回顾性分析我院收治的2例AIP临床资料并复习相关文献。结果本组例1以腹痛、黄疸入院,例2以左上腹疼痛入院,均在外院行影像学检查而误诊为胰腺占位性病变,为进一步诊治入我院,入院后经相关影像学检查、血清免疫学检查及糖皮质激素试验性治疗后临床症状及影像学表现明显改善,临床确诊为AIP。2例均带药出院,至症状、胰腺影像学形态正常后停药,随访无复发。结论对AIP缺乏诊治经验是该病误诊原因之一,临床接诊此类患者对应综合分析其影像学表现、血清免疫学检查结果及糖皮质激素治疗效果,以及时对AIP作出正确诊断并治疗。Objective To enhance clinical awareness of autoimmune pancreatitis （AIP） in order to avoid misdiagnosis and mistreatment. Methods Clinical data of 2 patients with AIP treated in our hospital was retrospectively analyzed, and rele- vant literature was also reviewed. Results One patient was admitted for abdominal pain and jaundice, and the other was admit- ted for left upper abdominal pain. Both were misdiagnosed as having pancreatic occupying lesion by imaging examinations in oth- er hospitals, and were hospitalized in our hospital for further diagnosis and treatment. The diagnosis of AIP was confirmed after relevant imaging examinations, seroimmunologieal test, and obvious improvements of the two patients＇clinical symptoms and ima- ging examination results were made following trial glueocortieosteroid therapy. Medications were prescribed for the patients after discharge from our hospital, and were stopped after symptoms disappearance and normal pancreatic imaging findings. There was no recurrence during the follow-up. Conclusion Lack of experience in diagnosis and treatment of AIP is one of the misdiagnosis causes, so clinicians should comprehensively evaluate pancreatic imaging findings, result of seroimmunological test and effects of glucoeorticosteroid treatment in order to make a correct diagnosis in time.

关 键 词：自身免疫性胰腺炎 误诊 胰腺肿瘤 

分 类 号：R576[医药卫生—消化系统]