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step-up approach in emphysematous hepatitis: A case report

World Journal of Hepatology 2022年第2期14卷 464-470页

作者： Silke Francois Maridi Aerts Hendrik Reynaert Ruth Van Lancker Johan Van Laethem Rastislav Kunda Nouredin Messaoudi Department of Gastroenterology Universitair Ziekenhuis BrusselBrussels 1090Belgium Department of Gastroenterology and Hepatology Vrije Universiteit BrusselUniversitair Ziekenhuis BrusselBrussels 1090Belgium Department of Intensive Care Vrije Universiteit BrusselUniversitair Ziekenhuis BrusselBrussels 1090Belgium Department of Infectious Diseaeses Vrije Universiteit BrusselUniversitair Ziekenhuis BrusselBrussels 1090Belgium Department of Surgery Vrije Universiteit BrusselUniversitair Ziekenhuis BrusselBrussels 1090Belgium Department of Surgery Europe HospitalsBrussels 1180Belgium

BACKGROUND Emphysematous hepatitis(EH)is a rare,rapidly progressive fulminant gasforming infection of the liver *** is often fatal and mostly affects diabetes *** SUMMARY We report a case of EH successfully managed by a step-up approach consisting of aggressive hemodynamic support,intravenous antibiotics,and percutaneous drainage,ultimately followed by laparoscopic *** 11 documented cases worldwide,only 1 of the patients survived,treated by urgent laparotomy and surgical *** EH is a life-threatening *** high mortality rate makes timely diagnosis essential,in order to navigate treatment accordingly.

关键词： Emphysematous hepatitis Septic shock step-up approach Percutaneous drainage Laparoscopic deroofing Case report

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SARS-CoV-2 and the pancreas: What do we know about acute pancreatitis in COVID-19 positive patients?

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World Journal of Gastroenterology 2022年第36期28卷 5240-5249页

作者： Giuseppe Brisinda Maria Michela Chiarello Giuseppe Tropeano Gaia Altieri Caterina Puccioni Pietro Fransvea Valentina Bianchi Department of Medical and Surgical Sciences Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Medicine and Surgery UniversitàCattolica del Sacro CuoreRome 00168Italy Department of Surgery Azienda Sanitaria Provinciale di CosenzaCosenza 87100Italy Emergency Surgery and Trauma Center Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)can cause pancreatic damage,both directly to the pancreas via angiotensin-converting enzyme 2 receptors(the transmembrane proteins required for SARS-CoV-2 entry,which are highly expressed by pancreatic cells)and indirectly through locoregional vasculitis and *** that,there is no clear evidence that SARS-CoV-2 is an etiological agent of acute *** pancreatitis in coronavirus disease 2019(COVID-19)positive patients often recognizes biliary or alcoholic *** prevalence of acute pancreatitis in COVID-19 positive patients is not exactly ***,COVID-19 positive patients with acute pancreatitis have a higher mortality and an increased risk of intensive care unit admission and necrosis compared to COVID-19 negative *** respiratory distress syndrome is the most frequent cause of death in COVID-19 positive patients and concomitant acute *** this article,we reported recent evidence on the correlation between COVID-19 infection and acute pancreatitis.

关键词： Acute pancreatitis SARS-CoV-2 Severe acute pancreatitis Multiparametric scores Infected necrosis step-up approach

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Acute necrotizing pancreatitis: challenges and interventions-a narrative review

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Journal of Pancreatology 2022年第4期5卷 40-82页

作者： Yan Luo Le Li Rui Kong Yuhang Sui Bei Sun Department of Pancreatic and Biliary Surgery the First Affiliated Hospital of Harbin Medical UniversityHarbinChina Key Laboratory of Hepatosplenic Surgery Ministry of Educationthe First Affiliated Hospital of Harbin Medical UniversityHarbinChina

Acute pancreatitis(AP)is a complicated disease with rising incidence over the years.20%of AP will develop into acute necrotizing pancreatitis(ANP).Interventions for ANP have evolved from traditional open surgery to minimally invasive step-up *** pancreatic necrosis(IPN)is the most serious event of ANP and associated with extremely poor *** CT-based classification of IPN describes various types of IPN and will help to carry out surgical interventions for each ***,many challenges are still remaining during the treatment of *** the balance between endoscopic and surgical approaches,and the selection of optimal timing of surgical intervention for infected *** nowadays treatment scenario of ANP,the necessity for open surgery remains to be *** of the development of advanced interventional techniques,postoperative residual infection(PRI)remains thorny,and effective prevention and treatment of PRI is of significance.

关键词： acute pancreatitis acute necrotizing pancreatitis step-up approach postoperative residual infection infected pancreatic necrosis

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一处罕见的感染性胰腺坏死的肝外液体积聚区:腹股沟阴囊区

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Gastroenterology Report 2016年第3期4卷 246-250,I0003页

作者： Saurabh Kalia Rahul Gupta Sunil DShenvi Hemanth Kumar Rajesh Gupta Mandeep Kang Surinder Singh Rana Deepak Kumar Bhasin Rajinder Singh Surgical Gastroenterology Division Department of General SurgeryPostgraduate Institute of Medical Education and ResearchChandigarhIndia Department of Radiology Postgraduate Institute of Medical Education and ResearchChandigarhIndia Department of Gastroenterology Postgraduate Institute of Medical Education and ResearchChandigarhIndia

Severe acute pancreatitis often leads to pancreatic and peripancreatic collections but,rarely,it can lead to collections at sites remote from the *** male patients presented with abdominal pain and inguinoscrotal *** were initially misdiagnosed with obstructed inguinal hernia,epididymo-orchitis and hydrocele,***,their diagnosis of acute pancreatitis was revealed on laparotomy in one patient and on computed tomography(CT)in the remaining two *** these cases had extensive peripancreatic necrosis and paracolic collections tracking along the psoas muscle,downwards towards the *** collections were initially managed by percutaneous drainage and saline irrigation as a part of the‘step-up’*** of these patients required open necrosectomy,while all required incision and drainage of inguinoscrotal *** the patients were discharged in satisfactory *** swelling is unusual as a first presentation of acute pancreatitis.A high index of suspicion,with careful study of patient’s history and examination along with CT,may provide an accurate *** drainage may be required to control sepsis and also provide an egress route for intra-abdominal collections.

关键词： acute pancreatitis inguinoscrotal collections step-up approach necrosectomy

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