急性腸炎引起高脂肪酶血症仿似急性胰臟炎

Acute enteritis Induced Hyperlipasmia Mimicking Acute Pancreatitis: A Rare Case Report Acute Pancreatitis: A Rare Case Report

急性腸炎引起高脂肪酶血症是一個十分不常見的原因，因此需要與急性胰臟炎作鑑別診斷。在有限的預算之下，醫師會選擇有較高準確率的血液脂肪酶作為排除 胰臟炎之檢查，因此急性腸炎引起的高脂肪酶血症會讓醫師做出錯誤的處置，而延遲了急性嚴重性腸炎的治療。因此，我們在此提出一個急性嚴重性腸炎誘發高脂肪 酶血症的個案，並探討高脂肪酶血症的鑑別診斷與治療，希望提供臨床醫師能較早介入處理，特別是在急性嚴重性腸炎的病人。

 

Background: Hyperlipasemia is rarer than hyperamylasemia. Previous studies reported hyperlipasemia possibly displays three or more times the normal upper limit in inflammatory bowel disease, such as Crohn’s disease and ulcerative colitis. Enteritis is a rare cause of hyperlipasemia.
Case Report: We describe a case of a 58-year-old male with epigastric pain, vomiting and diarrhea with markedly elevated serum lipase. Acute pancreatitis was suspected. However, CT findings revealed acute infectious enteritis and stool exam showed an inflammatory status. Following antibiotic treatment, lipase declined within normal range from three times the normal upper limit. After one week, the lipase was within normal range and no complication was noted.
Conclusion: Severe infection and inflammation induced by acute enteritis may cause hyperlipasemia.