胰腺假性囊肿感染伴蜂窝织炎超声表现1例

2017-11-30 佚名 中国临床医学影像杂志

女,74岁

【一般资料】

女,74岁

【现病史】

3月前因胆囊结石伴急性胆囊炎行“胆囊造瘘术”,随后出现胆总管结石,淀粉酶增高诊断为急性胰腺炎,并行ERCP取石术。本次住院主因间断性左下腹痛伴发热1周,

【体格检查】

上腹及左下腹压痛,无反跳痛,无肌紧张,左腰部触痛,张力较高,白细胞计数:11.20×109L-1,中性粒细胞百分比:80.0%,中性粒细胞绝对值:9.00×109L-1,CT示:慢性胰腺炎,胰腺假性囊肿形成。

【辅助检查】

【初步诊断

慢性胰腺炎假性囊肿伴感染,胆囊造瘘术后。

【治疗】

本次住院治疗期间患者出现咳嗽,咳痰,胸闷,气短,复查CT示:双侧胸腔积液,肺部炎性改变。左腰部、臀部及大腿外侧疼痛,可见弥漫性红肿,皮温增高,压痛明显,指凹性水肿,临床考虑急性蜂窝织炎不除外。遂行超声检查,超声表现:腰部腹膜后间隙(胰尾后方-腰背部皮下)可探及不规则低回声区(图1),近似液性暗区,范围约13.0cm×6.5cm×5.8cm;左侧臀部浅表层局部回声减低,与上述不规则低回声相延续(图2,3)。超声提示:①腰部腹膜后间隙脓肿?②左侧臀部皮下炎性病变可能。当日行超声引导下介入治疗脓肿穿刺置管术,术中可见脓液流出,置管成功。


版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1632659, encodeId=9ad416326593b, content=<a href='/topic/show?id=676d92821e3' target=_blank style='color:#2F92EE;'>#超声表现#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92821, encryptionId=676d92821e3, topicName=超声表现)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4dfe21938258, createdName=zhangjingnwpu, createdTime=Tue May 01 15:43:00 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1928318, encodeId=fd9d1928318fc, content=<a href='/topic/show?id=3c472e5555e' target=_blank style='color:#2F92EE;'>#假性囊肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27555, encryptionId=3c472e5555e, topicName=假性囊肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Sat Dec 02 21:43:00 CST 2017, time=2017-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266147, encodeId=995826614e03, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sat Dec 02 09:40:27 CST 2017, time=2017-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1340762, encodeId=848d1340e62d9, content=<a href='/topic/show?id=74a140404de' target=_blank style='color:#2F92EE;'>#囊肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40404, encryptionId=74a140404de, topicName=囊肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32a12500167, createdName=12498ca5m83暂无昵称, createdTime=Sat Dec 02 08:43:00 CST 2017, time=2017-12-02, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1632659, encodeId=9ad416326593b, content=<a href='/topic/show?id=676d92821e3' target=_blank style='color:#2F92EE;'>#超声表现#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92821, encryptionId=676d92821e3, topicName=超声表现)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4dfe21938258, createdName=zhangjingnwpu, createdTime=Tue May 01 15:43:00 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1928318, encodeId=fd9d1928318fc, content=<a href='/topic/show?id=3c472e5555e' target=_blank style='color:#2F92EE;'>#假性囊肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27555, encryptionId=3c472e5555e, topicName=假性囊肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Sat Dec 02 21:43:00 CST 2017, time=2017-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266147, encodeId=995826614e03, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sat Dec 02 09:40:27 CST 2017, time=2017-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1340762, encodeId=848d1340e62d9, content=<a href='/topic/show?id=74a140404de' target=_blank style='color:#2F92EE;'>#囊肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40404, encryptionId=74a140404de, topicName=囊肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32a12500167, createdName=12498ca5m83暂无昵称, createdTime=Sat Dec 02 08:43:00 CST 2017, time=2017-12-02, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1632659, encodeId=9ad416326593b, content=<a href='/topic/show?id=676d92821e3' target=_blank style='color:#2F92EE;'>#超声表现#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92821, encryptionId=676d92821e3, topicName=超声表现)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4dfe21938258, createdName=zhangjingnwpu, createdTime=Tue May 01 15:43:00 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1928318, encodeId=fd9d1928318fc, content=<a href='/topic/show?id=3c472e5555e' target=_blank style='color:#2F92EE;'>#假性囊肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27555, encryptionId=3c472e5555e, topicName=假性囊肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Sat Dec 02 21:43:00 CST 2017, time=2017-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266147, encodeId=995826614e03, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sat Dec 02 09:40:27 CST 2017, time=2017-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1340762, encodeId=848d1340e62d9, content=<a href='/topic/show?id=74a140404de' target=_blank style='color:#2F92EE;'>#囊肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40404, encryptionId=74a140404de, topicName=囊肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32a12500167, createdName=12498ca5m83暂无昵称, createdTime=Sat Dec 02 08:43:00 CST 2017, time=2017-12-02, status=1, ipAttribution=)]
    2017-12-02 半夏微凉

    学习了谢谢分享

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1632659, encodeId=9ad416326593b, content=<a href='/topic/show?id=676d92821e3' target=_blank style='color:#2F92EE;'>#超声表现#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92821, encryptionId=676d92821e3, topicName=超声表现)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4dfe21938258, createdName=zhangjingnwpu, createdTime=Tue May 01 15:43:00 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1928318, encodeId=fd9d1928318fc, content=<a href='/topic/show?id=3c472e5555e' target=_blank style='color:#2F92EE;'>#假性囊肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27555, encryptionId=3c472e5555e, topicName=假性囊肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Sat Dec 02 21:43:00 CST 2017, time=2017-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=266147, encodeId=995826614e03, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sat Dec 02 09:40:27 CST 2017, time=2017-12-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1340762, encodeId=848d1340e62d9, content=<a href='/topic/show?id=74a140404de' target=_blank style='color:#2F92EE;'>#囊肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40404, encryptionId=74a140404de, topicName=囊肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32a12500167, createdName=12498ca5m83暂无昵称, createdTime=Sat Dec 02 08:43:00 CST 2017, time=2017-12-02, status=1, ipAttribution=)]

相关资讯

Nat Cell Biol:科学家利用干细胞生产胰腺β细胞,糖尿病治愈出现新曙光!

在哥本哈根大学进行的一项新的干细胞研究表明,我们可能会如何增加糖尿病患者的胰岛素生产。这一发现有助于以更低的成本更有效地从人类干细胞中制造产生胰岛素的β细胞。因此,该研究为更有效地治疗糖尿病铺平了道路。该方法也可能对一系列其他疾病的治疗有重要意义。

Br J Surg:营养评估评分或对胰腺手术无足轻重

2017年3月,《Br J Surg》上发表了由德国科学家进行的胰腺手术中不同营养评估评分的预后意义的前瞻性试验(NURIMAS胰腺)。

Gastroenterol:广州医科大学唐道林教授团队发现治疗胰腺癌的新药物和新机制

近日,广州医科大学附属第三医院特聘教授唐道林带领的团队,在胰腺癌的治疗领域取得了突破性进展,他们不仅发现了一种新的胰腺癌药物,还阐明了程序性坏死的新型调控分子机制。 对于缺医少药,且表现极度恶劣的胰腺癌而言,唐教授团队的新发现显得弥足珍贵。相关的研究成果刊登在消化领域顶级期刊《肠胃病学》(胃肠病学研究排名第1的期刊,2016年影响因子为18.392)上

Eur Radiol:天下武功唯快不破--实时多层技术扩散加权成像!

本研究旨在探究不同加速因子胰腺实时多层加速扩散加权成像(sms-DWI)的可行性及其较传统序列对图像质量、采集时间和表观扩散系数(ADCs)的影响,并将结果发表在Eur Radiol上。

J Immunol:科学家找到保护胰腺β细胞、预防1型糖尿病的方法!

杰克逊实验室,Cyteir治疗公司和合作机构的研究人员已经找到了一种方法来保护胰腺β细胞免受破坏——实现长期难以捉摸的目标,可能带来预防1型糖尿病(T1D)的治疗方法。

墨尔本大学:第一代人造胰腺投入使用,糖尿病患者受益颇多!

墨尔本大学正在研究的一种新的“人造胰腺”可以大大改变1型糖尿病患者的生活。