急性主动脉夹层并发急性胰腺炎一例并文献复习  

Acute aortic dissection complicated by acute pancreatitis: report of a case and literature review

作　　者：蒋鹏[1] 叶子[1] 蔡锐彬[1] 詹红[1] 周毅君 Karamath Mohammed 陈都[1] 廖晓星[1] 李欣[1] 熊艳[1] 

机构地区：[1]中山大学附属第一医院急诊科,广州510080

出　　处：《中华临床医师杂志（电子版）》2015年第10期49-52,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：卒中性肺炎早期诊治与预后相关的感染性指标物的临床系列研究(2012B061700086)

摘　　要：目的探讨主动脉夹层并发急性胰腺炎的临床特征、诊断与发病机制,以提高临床医师对此病的认识。方法分析1例主动脉夹层并发急性胰腺炎患者的临床表现、影像学检查、实验室检查结果并进行相关文献复习。结果本病例因突发上腹疼痛入院,结合影像学与实验室检查诊断为主动脉夹层并发急性胰腺炎,考虑外科治疗,等待手术期间病情恶化,自动出院。结合8篇国内外主动脉夹层并发胰腺炎的文献,共9例,所有患者经CT/MRI检查与实验室血淀粉酶检测确定诊断,其中,DebakeyⅢ型主动脉夹层6例,De BakeyⅠ型主动脉夹层2例,1例未知。结论主动脉夹层并发急性胰腺炎非常少见,容易漏诊,可借助影像学检查与实验室检查进行鉴别诊断。主动脉夹层可通过多种发病机制引发急性缺血性胰腺炎,其两者之间的关系需要更多研究证实。Objective To explore the clinical characteristics, diagnosis, and pathogenesis of acute aortic dissection （AD） complicated with acute panereatitis （AP） so as to improve the diagnosis process. Methods A ease of acute AD complicated with AP was analyzed. Nine cases with the same diagnosis, including this case, were collected from the recent literatures and analyzed together. Results The first clinical manifestation of this case was severe epigastric pain and the diagnosis was based mainly on imaging and laboratory results. This patient discharged voluntarily and was lost to follow-up. Of the 9 cases, 6 cases were Debakey HI acute AD, 2 were DeBakey I acute AD, and one ease was unknown type. All the patients were diagnosed by imaging studies and serum analyses. Conclusions Acute AD complicated with AP is uncommon and easy to be misdiagnosed. AP may cause AP via different pathogeneses.

关 键 词：主动脉夹层 急性胰腺炎 诊断 发病机制 

分 类 号：R543.1[医药卫生—心血管疾病]