A previously well 43-year-old men was admitted with right upper quadrant and epigastric pain, fever and vomiting. His medical history included asymptomatic cholestatic liver function tests for which serial ultrasound (US), magnetic resonance cholangiopancreatography, fibroscan and a US-guided liver biopsy had proved unremarkable several years prior to this presentation. Physical examination revealed diffuse abdominal tenderness worst in the right upper quadrant and epigastric region. Laboratory investigations demonstrated raised inflammatory markers and deranged liver function but were otherwise unremarkable. CT of the abdomen and pelvis showed extensive pancreatic stranding and fluid most prominent around the tail and body of the pancreas. The patient had no history of gallstones, alcohol misuse, new medications, family history or hypercholesterolemia. The patient was managed conservatively but subsequently deteriorated with features of abdominal sepsis. Serial …

中文翻译：

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急性胰腺炎的独特病因


一名原本健康的 43 岁男性因右上腹和上腹疼痛、发烧和呕吐入院。他的病史包括无症状胆汁淤积性肝功能检查，在本次就诊前几年，连续超声（US）、磁共振胰胆管造影、纤维扫描和超声引导的肝活检已证明这些检查无异常。体检发现右上腹和上腹部弥漫性腹部压痛最严重。实验室检查显示炎症标志物升高和肝功能紊乱，但在其他方面并不显着。腹部和骨盆 CT 显示广泛的胰腺绞合和胰尾和胰体周围最明显的液体。患者没有胆结石、酗酒、新药、家族史或高胆固醇血症病史。该患者接受了保守治疗，但随后病情恶化，出现腹部脓毒症。串行…