妊娠に伴う高脂血症が誘因となった急性膵炎の1例 A CASE OF ACCUTE PANCREATITIS CAUSED BY HYPERLIPIDEMIA WITH PREGNANCY

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高脂血症が誘因となった妊娠時急性膵炎の1治験例を報告する.患者は27歳,女性で妊娠32週目.嘔吐と上腹部痛を主訴に来院した.腹部は全体に膨隆し妊娠子宮の上縁を臍上部3横指の位置に触知.また,心窩部を中心に圧痛を認めたが,反跳痛や筋性防御はなかった.入院時検査成績では,白血球数が18,410/mm<sup>3</sup>と増加し,生化学的には総コレステロール値749mg/dl,中性脂肪値5,632mg/dl,血清アミラーゼ値9,411U/L,尿中アミラーゼ値4,724U/Lと異常高値を示した.腹部超音波検査では膵は全体に腫大し辺縁が不鮮明であった.中等度急性膵炎の診断のもと保存的治療を開始したが,治療開始翌日には胎児に変調がみられたため帝王切開術により胎児を娩出した.同時に腹腔内および膵床ドレナージ術を施行した.術後経過は良好で,血液生化学的検査値の正常化とともに全身状態も改善し術後45病日に退院した.術後3年4カ月の現在,母子共に健在である.

A case of acute pancreatitis caused by hyperlipidemia during pregnancy is reported.<br> A 27-year-old pregnant woman of the 32nd week gestation was seen at the hospital because of vomiting and upper abdominal pain. The abdomen was entirely distended, and the upper margin of the gastated uterus was palpated three fingers above the navel. There was tenderness centering the region of the epigastric fossa, but no rebound tenderness nor muscle guarding was presented. Laboratory data on admission revealed increased white blood cell count of 18, 410/mm<sup>3</sup>. Biochemically, total cholesterol, neutoral fat, serum amylase, and urinary amylase levels were as abnormally high as 749mg/dl, 5, 632mg/dl, 9, 411U/L, and 4, 724U/L, respectively. Abdominal ultrasonography visualized the pancreas which swelled generally and had an obscure margin. Conservative therapy was started under a diagnosis of acute pancreatitis of mild degree. On the next day, some alterations were seen in the fetus and the fetus was delivered by a cesarean section. Simultaneously, intraperitoneal and pancreas bed drainage were performed. Postoperative course was uneventful. Blood biochemical data were normalized and the general condition improved as well. The patient was discharged from the hospital on 45th hospital day. Both the patient and her baby have been in good health, as of 3 years and 4 months.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 61(2), 486-490, 2000-02-25

    Japan Surgical Association

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各種コード

  • NII論文ID(NAID)
    10008502134
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  J-STAGE 
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