Moderate acute pancreatitis with pleural effusion and impaired kidney functions

1st International Conference on Tropical Medicine and Infectious Diseases (ICTROMI) Faculty of Medicine Universitas Sumatera Utara

Lumbantoruan, O.H.^1 ; Dairi, L.B.^1

Division of Gastroenterohepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia^1

关键词: Abdominal pain;    Acute pancreatitis;    Emergency departments;    Inflammatory reaction;    Kidney function;    Lipase enzyme;    Pleural effusion;    Proton pump inhibitors;   

Others  :  https://iopscience.iop.org/article/10.1088/1755-1315/125/1/012210/pdf
DOI  :  10.1088/1755-1315/125/1/012210

来源: IOP

【 摘 要 】

Acute pancreatitis is a pancreatic inflammatory reaction that is clinically characterized by acute abdominal pain accompanied by elevated amylase and lipase enzymes. A 57-year-old female patient came to the emergency department with the main complaint of localized pain in the epigastric region within the last three days. Blood pressure 130/90mmHg, pulse 90x/i, RR 20x/i, temperature 37°C, sub-icteric on the eyes and tenderness in the epigastric region. Laboratory findings were leukocytosis, increased amylase, and lipase, elevated liver enzymes, hypoalbuminemia, elevated Kidney Functions, acidosis, and hypoglycemia. Abdominal CT-Scan revealed a partially lobulated edge with solid and necrotic components of the caput pancreas and widespread suspicion to the pancreatic corpus. The mass appeared to cause widening of the biliary and intrahepatic systems with minimal right pleural effusion. The liverwas slightly enlarged. The patient was with acute pancreatitis and treated with the installation of an open nasogastric tube, and resuscitated with ringer lactate fluid followed by IVFD D5%. Patients fasted for three days before giving a low fat, protein diet, antibiotic and proton pump inhibitors for seven days. After nine days, amylase and lipase levels decreased with significant clinical improvement. The next three days, the patient was discharged.