胰腺疾病中山大學內科學(編輯修改稿)
2025-02-12 17:33 本頁面
【文章內容簡介】 esponse syndrome ? MODS multiple an dysfunction syndrome Laboratory ? Serum amylase and lipase levels ? Serum calcium ? blood glucose ? arterial blood gas ? white blood cell count Laboratory Findings Imaging studies ? Chest/abdominal radiographs ? Ultrasound ? CT ? MRI ? MRCP contrast CT mild pancreatitis bleeding and necrotic focuses hemorrhagic focus pseudocyst Admission Age 55 yr WBC16000/mm3 Glucose 200 mg/dL LDH350 IU/L AST250 IU/L Initial 48 hrs Hct fall 10% BUN elevation 5mg/dL Ca2+ 2mmol/L PaO260mmHg Base deficit4mmol/L Fluid sequestration6L 3 or 4 signs mortality 15%, 7 or 8 signs mortality 90% Ranson’s Prognostic Signs Differential diagnosis ? acute cholangitis / cholecystitis ? perforated hollow viscus ? bowel obstruction ? mesenteric ischemia / infarction ? acute gastroenteritis ? acute myocardial infarction The stages of course ? stage of acute reaction – within 2w ? stage of systemic infection – 2w2m ? stage of residual infection later than 23m usually but not always Local plications ? acute fluid collection ? pancreatic and peripancreatic necrosis ? pancreatic pseudocyst ? pancreatic abscess Treatment nonoperative therapy 1. fasting diet, gastric suction 2.
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