解决问题的问题:局部麻醉相关的急性胰腺炎病例
Jeffrey Robles1, Dillon Rogando2, Tara Ranjbar2
1Surgery, Northwell Health Staten Island University Hospital/City University of New York School of Medicine, New York, USA.
局部麻醉系统毒性 (LAST) 可能导致心血管崩,其用脂质乳液治疗可能导致胰腺炎. 这个病例详细介绍了一个患者在LAST治疗后发展出严重的胰腺炎,通过先进的胃肠道干预成功管理.
科学领域:
- 麻醉学 麻醉学
- 胃肠病学 胃肠病学
- 毒理学 毒理学 毒理学
背景情况:
- 局部麻醉系统毒性 (LAST) 是局部麻醉的罕见但严重的并发症,可能导致心血管崩.
- 脂质乳液疗法是LAST的标准治疗方法,但它可以矛盾地诱导胰腺炎.
研究的目的:
- 介绍一个病人的病例,该病人在LAST的脂质乳液治疗后出现了严重的瘤性胰腺炎.
- 突出这一罕见并发症的诊断和管理挑战.
主要方法:
- 一名71岁的女性在腕阻塞后出现了胸和低血压,被怀疑是LAST.
- 开始用脂质乳液治疗,随后出现严重的胰腺炎,由高酶和CT成像证实.
- 进行了先进的内镜干预,用于大量的胰腺液收集,导致胆道阻塞.
主要成果:
- 患者经历了急性死性胰腺炎,胰腺亡显著,大量的液体积聚导致胆道阻塞.
- 通过胃经囊腔胃切除术和支架安置的成功管理导致症状的缓解和肝功能测试的正常化.
- 患者在胰腺炎相关并发症的缓解后出院.
结论:
- 脂质乳液治疗虽然对LAST至关重要,但存在诱导严重胰腺炎的风险.
- 涉及麻醉学,重症监护和先进的胃肠道学的多学科管理对于这些复杂的病例至关重要.
- 内镜干预可以有效地管理大量的胰腺液收集,导致胰腺炎的次要胆道阻塞.
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