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Anterior abdominal wall abscess with epididymo-orchitis: An unusual presentation of acute pancreatitis

机译:前腹壁脓肿伴附睾睾丸炎:急性胰腺炎的异常表现

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Pancreatitis indicates inflammation of the pancreas. Clinically acute pancreatitis typically presents as upper abdominal pain mostly in epigastric region, nausea, vomiting and elevated levels of amylase and lipase. Depending upon severity of acute pancreatitis patient may presents with minimal symptoms to more severe signs of acute abdomen like generalized guarding and rigidity. Inspite of absence of disease-specific signs and symptoms for acute pancreatitis, diagnosis is usually not difficult using a combination of clinical, laboratory and radiological findings. Sometimes pancreatitis may presents atypically, which may be misleading in the management especially when typical presentation of pancreatitis as described above is absent. We have described a case of pancreatitis where patient presented with anterior abdominal wall abscess with epididymo-orchitis because of tracking of pancreatic fluid into the retroperitoneum till scrotum. Patients presentation may be different depending upon complication occurred during the course of pancreatitis. After reviewing the literature we found very few cases in which you may not get a clue to diagnose pancreatitis because of atypical presentation. In the described case, patient managed conservatively with percutaneous drainage of the abscess by pigtail catheter placement and scrotal support for epididymoorchitis. This avoided unnecessary exploration in above patient.
机译:胰腺炎表明胰腺发炎。临床上急性胰腺炎通常表现为上腹部疼痛,主要表现在上腹部,恶心,呕吐以及淀粉酶和脂肪酶水平升高。根据急性胰腺炎的严重程度,患者可能会表现出最小的症状,出现诸如全身防护和僵硬等更严重的急性腹部体征。尽管没有针对急性胰腺炎的疾病特定症状和体征,但结合临床,实验室和放射学检查结果通常不难诊断。有时胰腺炎可能会不典型地出现,这可能会在治疗中产生误导,尤其是在没有上述典型胰腺炎表现时。我们描述了一个胰腺炎病例,该患者由于伴有胰液进入腹膜后直至阴囊而出现前腹壁脓肿并附睾睾丸炎。根据胰腺炎过程中发生的并发症,患者的表现可能会有所不同。查阅文献后,我们发现很少有病例由于非典型表现而无法获得诊断胰腺炎的线索。在所描述的情况下,患者可通过猪尾导管放置和阴囊支持附睾性睾丸炎保守治疗脓肿的经皮引流。这避免了在上述患者中不必要的探索。

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