2019, Number 1
Rev Hosp Jua Mex 2019; 86 (1)
Hemorrhagic-necrotic pancreatitis as a trigger for severe diabetic ketoacidosis in a young patient
González-Becerril F, Flores-Galicia CP, Zavaleta-Ramírez E
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Language: Spanish
References: 16
Page: 55-59
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ABSTRACT
Introduction: Pancreatitis is a condition resulting from the abnormal activation of pancreatic enzymes, which overcomes the mechanisms of self-protection, which can occur from mild to severe forms reaching a mortality of more than 50%. Objectives: To report an atypical form of metabolic decompensation secondary to severe pancreatitis in a young patient. Clinical case: Female, 16 years old, begins her ailment one month prior to admission, with abdominal pain type colic and urent epigastrium with irradiation to the back, she went to a rural clinic treated with analgesics and antacids without improvement, later presenting intolerance to the oral route, polyuria, polydipsia. She is referred to this unit; when she was admitted to the emergency department, she presents hyperglycemia and severe metabolic acidemia, starting with management and multi-organ support, evolving into multiple organic failures (renal, hemodynamic and pulmonary). Contrasted abdominal tomography was performed and extensive pancreatic necrosis was found, optimizing resuscitation, later evaluated by the General Surgery Service, who decide emergency surgical intervention, confirming extensive pancreatic necrosis, performing 95% pancreatic necrosectomy, continuing with multiorgan support in the intensive care unit, finally evolving satisfactorily, with remission of organic faults. Conclusions: There is a relationship between ketoacidosis pancreatitis of approximately 10% which denotes a high mortality, however there are other forms of presentation of these two entities in which necrotic hemorrhagic pancreatitis was identified as the initial cause of the disease, so we consider it important to review the most current aspects of this pathological entity.REFERENCES
Boadas J, Balsells J, Busquets J, Codina BA, Darnelle A, Garcia BF, et al. Valoración y tratamiento de la pancreatitis aguda. Documento de posicionamiento de la Societat Catalana de Digestologia, Societat Catalana de Cirurgia y Societat Catalana de Pàncrees. Gastroenterol Hepatol 2015; 38(2): 82-96.