胰腺性脂膜炎——超声个案分析

Ultrasound analysis for pancreatic panniculitis: A case report

胰腺脂膜炎是一种与胰腺病变密切相关的皮下脂肪坏死性炎症,在胰腺疾病患者中出现的比例为2%~3%,多见于老年人,最常累及四肢,表现为皮肤炎症伴疼痛和红斑结节。报告1例急性胰腺炎合并胰腺性脂膜炎的病例,该患者为老年女性,因呕吐、腹痛3日入院,患者2周前出现双下肢皮下红斑结节,至入院时结节明显增多。实验室和超声检查提示急性胰腺炎。高频超声显示皮下软组织层和脂肪层内出现低回声灶。皮肤组织学病理符合胰腺性脂膜炎诊断。该患者的结节随着急性胰腺炎症的消退而消失。胰腺性脂膜炎可能是胰腺疾病的首发表现,相关影像学研究不足,超声诊断经验值得积累。

Pancreatic panniculitis(PP) is a necrotizing inflammation of subcutaneous fat that is a rare complication of pancreatic disease appearing in 2% to 3% of all patients. It is more common in the elderly and often affects the extremities. It presents as skin inflammation with pain and erythema nodules. We report a case of acute pancreatitis associated with PP in an old female. She was admitted for vomiting and abdominal pain for 3 days and presented with a 2-week history of erythematous subcutaneous nodules on her legs.Laboratory and ultrasonic findings revealed acute pancreatitis. High frequency ultrasound showed hypoechoic foci in subcutaneous soft tissue layer and adipose layer.Histopathological examination confirmed the diagnosis of PP. Nodules disappeared with the resolution of acute pancreatic inflammation. PP may be the first manifestation of pancreatic disease. Imaging features of this pathology are seldom described and ultrasonic diagnosis experience is worth to be accumulated.