邹龙;王强;吴晰;王志伟;杨爱明;
ZOU Long;WANG Qiang;WU Xi;WANG Zhiwei;YANG Aiming;Department of Pathology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

• 1:中国医学科学院北京协和医院病理科
• 2:中国医学科学院北京协和医院消化内科
• 3:中国医学科学院北京协和医院放射科

摘要(Abstract)：

本文报道1例具有阿司匹林加重性呼吸系统疾病病史的患者，出现嗜酸性粒细胞性肠炎和复发性急性胰腺炎。此病例具有多系统受累临床特征及嗜酸性粒细胞浸润组织学表现，故临床疑诊为嗜酸性肉芽肿性多血管炎。患者合并出现急性胰腺炎是该疾病非常少见的临床表现；此外，患者存在胰腺假性囊肿，囊肿穿刺引流术后出现迟发性假性动脉瘤出血，经血管造影栓塞治疗后成功止血，术后1年复查病情稳定。该病例的诊断和处理过程复杂，其诊治经验值得临床医师借鉴。
This was a patient with a medical history of aspirin-aggravated respiratory disease present with eosinophilic enteritis and recurrent acute pancreatitis. Eosinophilic granulomatosis with polyangiitis was clinically suspected due to the clinical presentation of multiple systems and the histological appearance of eosinophilic infiltrate, but acute pancreatitis was rarely reported in this disease. In addition, the patient developed pancreatic pseudocyst, and delayed pseudoaneurysm hemorrhage occurred after drainage of the pseudocyst. The hemorrhage was successfully treated after angiographic embolization, and the patient remained stable after one year. The case was reported here because both the diagnosis and the management were challenging and worth learning.

关键词(KeyWords)： 嗜酸性粒细胞性肠炎;急性胰腺炎;阿司匹林加重性呼吸系统疾病;嗜酸性肉芽肿性多血管炎;假性动脉瘤出血
eosinophilic enteritis;acute pancreatitis;aspirin-aggravated respiratory disease;eosinophilic granulomatosis with polyangiitis;pseudoaneurysm bleeding

Abstract:

Keywords:

基金项目(Foundation): 北京市重点建设一流专业项目(2021zlgc1106)~~

作者(Authors): 邹龙;王强;吴晰;王志伟;杨爱明;
ZOU Long;WANG Qiang;WU Xi;WANG Zhiwei;YANG Aiming;Department of Pathology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Gastroenterology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

参考文献(References)：

• [1] Jiang TA,Xie LT.Algorithm for the multidisciplinary mana-gement of hemorrhage in EUS-guided drainage for pancreatic fluid collections[J].World J Clin Cases,2018,6:308- 321.
• [2] Mathew G,Ahmad H.Pancreatic Pseudoaneurysm[M].Treasure Island:StatPearls,2020.
• [3] Baek MS,Mok YM,Han WC,et al.A patient with eosino-philic gastroenteritis presenting with acute pancreatitis and ascites[J].Gut Liver,2014,8:224- 227.
• [4] Pinte L,Bicu C.Eosinophilic pancreatitis versus pancreatitis associated with eosinophilic gastroenteritis - a systematic review regarding clinical features and diagnosis[J].Rom J Intern Med,2019,57:284- 295.
• [5] Samter M,Beers RF Jr.Intolerance to aspirin.Clinical studies and consideration of its pathogenesis[J].Ann Intern Med,1968,68:975- 983.
• [6] Pesek RD,Reed CC,Muir AB,et al.Increasing Rates of Diagnosis,Substantial Co-Occurrence,and Variable Treatment Patterns of Eosinophilic Gastritis,Gastroenteritis,and Colitis Based on 10-Year Data Across a Multicenter Consortium[J].Am J Gastroenterol,2019,114:984- 994.
• [7] Itawaki A,Okada M,Kawashima K,et al.Eosinophilic Granulomatosis with Polyangiitis Initially Diagnosed as Eosinophilic Gastroenteritis[J].Intern Med,2020,59:1029- 1033.
• [8] Trivioli G,Terrier B,Vaglio A.Eosinophilic granulo-matosis with polyangiitis:understanding the disease and its management[J].Rheumatology (Oxford),2020,59:iii84-iii94.
• [9] Pagnoux C,Guilpain P,Guillevin L.Churg-Strauss syn-drome[J].Curr Opin Rheumatol,2007,19:25- 32.
• [10] Ball LL,Velasquez SA,Al Jammal OM,et al.Atypical eosinophilic granulomatosis with polyangiitis with spontane-ous aspirin reactivity and immunoglobulin E-mediated anaphylaxis[J].Ann Allergy Asthma Immunol,2021,127:506- 507.
• [11] Ameratunga R,Steele R.Eosinophilic granulomatosis with polyangiitis (Churg-Strauss vasculitis) presenting as Samter's triad[J].J Allergy Clin Immunol Pract,2018,6:280- 282.
• [12] Yagi H,Takahashi S,Kibe T,et al.An Autopsy Case of a 5-Year-Old Child with Acute Pancreatitis Caused by Eosinophilic Granulomatosis with Polyangiitis-like Necrotizing Vasculitis[J].Case Rep Rheumatol,2019,2019:9053747.
• [13] Marvisi M,Uccelli M.A huge pancreatic cyst in eosino-philic granulomatosis with polyangitis[J].Rheumatology (Oxford),2021,60:4443.
• [14] Berti A,Boukhlal S,Groh M,et al.Eosinophilic granulomatosis with polyangiitis:the multifaceted spectrum of clinical manifestations at different stages of the disease[J].Expert Rev Clin Immunol,2020,16:51- 61.