误诊为急性胃炎及肠梗阻的高脂血症性急性胰腺炎临床分析OACSTPCD

Objective To summarize the causes and preventive measures of hyperlipidemic acute pancreatitis(HAP)misdiagnosed as acute gastritis and intestinal obstruction.Methods The clinical data of 2 misdiagnosed HAP patients admit-ted from July 2022 to July 2023 were retrospectively analyzed.Results One patient in this group presented with nausea,vomiting and abdominal distension,and was initially diagnosed as emergency gastritis in another hospital,which was not re-lieved by symptomatic treatment and led to decreased urinary volume.After admission to our hospital,blood examination indi-cated renal insufficiency and hyperkalemia,and HAP was diagnosed by examination of blood amylase,lipase and lipid and whole abdominal CT examination.After 20 days of corresponding treatment,the patient recovered well and was discharged.Another patient was diagnosed as acute gastroenteritis due to upper abdominal pain accompanied by nausea and vomiting.After admission to our hospital,the abdominal X-ray examination showed air fluid level and no increase in the blood and urine amyl-ase,which was suspected to be intestinal obstruction.Symptomatic treatment was performed,and the abdominal pain did not improve.Then the laparotomy revealed pancreatic edema and necrosis,elevated ascites amylase,combined with elevated blood triglyceride and cholesterol,and HAP was diagnosed.At 15 days after treatment,the patient recovered well and was discharged.Conclusion The symptoms of abdominal pain in HAP patients are non-specific,and the results of hematuric am-ylase may be false negative.Insufficient understanding of this disease for the clinician may lead to misdiagnosis.It is necessa-ry to strengthen the clinician's understanding of HAP,carefully inquire about the history,develop the diagnosis idea,and per-form blood lipids,blood and urine amylase,abdominal B-ultrasound,CT and other examinations to reduce or avoid the early misdiagnosis of HAP.