急性胰臟炎合急性呼吸窘迫症及皮下脂肪壞死：病例報告

Acute Pancreatitis and Acute Respiratory Distress Syndrome with Subcutaneous Fat Necrosis

楊煦星(Shi-Shing Yang)

《中華民國急救加護醫學會雜誌》 13卷1期 (2002/03) Pp. 31-36

https://doi.org/10.30018/JECCM.200203.0005

摘要

嚴重的急性胰臟炎常被討論到之皮膚徵候包括Grey Turner’s sign，Cullen’s sign和皮下脂肪壞死；前二徵候僅見於小於3%之急性胰臟炎之病人，而皮下脂肪壞死更為罕見。筆者探討一嚴重急性胰臟炎合併皮下脂肪壞死之臨床病例。病例中患者為一32歲之男性，因急性腹痛送至急診，經實驗室檢查其血清澱粉酵素及脂肪酵素明顯升高；後經腹部電腦斷層掃瞄確定其為急性胰臟炎。患者住院二天胸部X光攝影呈現兩側肋膜積水及肺實質浸潤，其符合急性呼吸窘迫症（ARDS）診斷；住院第十天於胸前及雙大腿外側出現皮膚結節性紅疹，經組織切片確認為皮下脂肪壞死。

關鍵字

急性胰臟 ； 急性呼吸窘迫症 ； 皮下脂肪壞死

並列摘要

Subcutaneous manifestations of severe acute pancreatitis, including Grey Turner’s sign, Cullen’s sign, and subcutaneous fat necrosis are frequently discussed. The first two signs are seen in less than 3% of patients with severe acute pancreatitis, and subcutaneous fat necrosis is observed even less often. We report a case of severe acute pancreatitis with acute respiratory distress syndrome (ARDS) and subcutaneous fat necrosis .A 32 year-old man suffered from acute abdominal pain and was sent to the emergency room. His serum amylase and lipase were markedly elevated. Abdomen CT revealed acute pancreatitis. The day after admission, chest X/ray showed bilateral pleural effusion and diffuse infiltration in the lung parenchyma. On the tenth hospital day he developed subcutaneous erythematous nodular lesions over bilateral thighs. Pathology showed these were subcutaneous fat necrosis.

並列關鍵字

acute pancreatitis ； acute respiratory distress syndrome(ARDS) ； subcutaneous fat necrosis