急性膵炎の経過中に肝梗塞を合併した1例

Abstract

We report a rare case of acute pancreatitis with hepatic infarction. A 71- year-old woman was admitted to our hospital because of sudden upper abdominal pain and severe nausea. Physical examination revealed upper abdominal tenderness with mild muscle defense, and hepatomegaly. Blood examination revealed high levels of serum amylase and lipase. Abdominal echography showed swelling of the entire pancreas and bright lever. The patient was diagnosed as having acute pancreatitis. Abdominal CT scan on admission showed swelling of the pancreas and bilateral fluid collection behind the kidneys without liver abnormalities. The patient was treated with continuous intravenous drip injection of gabexate mesilate(30 mg/kg)and ulinastatin(150,000 IU)daily. On the 6th hospital day, serum amylase and lipase levels and liver dysfunction were normalized, and the patient's, subjective symptoms were diminished. However, on the 16th hospital day, she had right hypochondralgia, high grade fever, and mild liver dysfunction. A contrast- enhanced abdominal CT scan showed a small, wedge-shaped, low-attenuation area in the right lobe of the liver. Hepatic infarction was diagnosed. Although the patient was not treated because the infarction was small, she recovered quickly.