慢性胰腺炎的并发症
- Author
- Steven D Freedman, MD, PhD
Steven D Freedman, MD, PhD
- Professor of Medicine
- Harvard Medical School
- Section Editor
- David C Whitcomb, MD, PhD
David C Whitcomb, MD, PhD
- Section Editor — Pancreatic Diseases
- Professor of Medicine
- University of Pittsburgh School of Medicine
- Deputy Editor
- Shilpa Grover, MD, MPH, AGAF
Shilpa Grover, MD, MPH, AGAF
- Deputy Editor — Gastroenterology/Hepatology
- Assistant Professor of Medicine, Part-time
- Harvard Medical School
- Translators
- 王强, 主治医师
王强, 主治医师
- 北京协和医院消化内科
引言
慢性胰腺炎是一种炎症疾病，会导致胰腺发生永久结构性改变，使胰腺外分泌和内分泌功能受损。慢性胰腺炎的临床表现包括慢性腹痛，以及胰腺内分泌和外分泌功能障碍。也可能伴有胰腺癌。 (参见“成人慢性胰腺炎的临床表现和诊断”)
此外，慢性胰腺炎可伴有多种并发症。最常见的并发症是假性囊肿形成及十二指肠和胆总管的机械性梗阻；其次包括胰源性腹水或胸腔积液、脾静脉血栓形成伴门静脉高压，以及假性动脉瘤形成(特别是脾动脉)。
慢性胰腺炎的并发症及其治疗将总结在此。慢性胰腺炎治疗的其他方面(主要是疼痛和胰腺功能不全)将单独讨论。 (参见“慢性胰腺炎的治疗”)
假性囊肿
约10%的慢性胰腺炎患者出现假性囊肿。假性囊肿的形成由胰管破裂导致，而不是由急性胰腺炎情况下的胰周液体积聚(导致假性囊肿形成)所致。假性囊肿可为单发或多发，可大可小，可位于胰腺内或胰腺外。大多数假性囊肿与胰管系统相交通，并含有高浓度的消化酶。 (参见“包裹性胰腺积液(包括假性囊肿)”)
假性囊肿壁由邻近结构组成，如胃、横结肠系膜、大网膜，以及胰腺(影像 1)。胰腺假性囊肿的壁内侧由纤维组织和肉芽组织组成；不覆有上皮层，这使假性囊肿可与胰腺真正的囊性病变相鉴别。 (参见“胰腺囊肿的分类”)
Subscribers log in here
To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:Literature review current through: 2017-06 . | This topic last updated: 2017-04-04.The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.References- Yeo CJ, Bastidas JA, Lynch-Nyhan A, et al. The natural history of pancreatic pseudocysts documented by computed tomography. Surg Gynecol Obstet 1990; 170:411.
- Hammel P, Couvelard A, O'Toole D, et al. Regression of liver fibrosis after biliary drainage in patients with chronic pancreatitis and stenosis of the common bile duct. N Engl J Med 2001; 344:418.
- Runyon BA. Amylase levels in ascitic fluid. J Clin Gastroenterol 1987; 9:172.
- Gómez-Cerezo J, Barbado Cano A, Suárez I, et al. Pancreatic ascites: study of therapeutic options by analysis of case reports and case series between the years 1975 and 2000. Am J Gastroenterol 2003; 98:568.
- Kozarek RA, Ball TJ, Patterson DJ, et al. Endoscopic transpapillary therapy for disrupted pancreatic duct and peripancreatic fluid collections. Gastroenterology 1991; 100:1362.
- Beattie GC, Hardman JG, Redhead D, Siriwardena AK. Evidence for a central role for selective mesenteric angiography in the management of the major vascular complications of pancreatitis. Am J Surg 2003; 185:96.
Top