关键词: 急性胰腺炎, 急性坏死物积聚, 网膜囊坏死物破溃综合征

Abstract: The clinical features and treatment strategies of omental sac necrosis rupture syndrome in acute pancreatitis                   TONG Zhi-hui, LI Wei-qin. Severe Acute Pancreatitis Treatment Center, Jinling Hospital, Medical School of Nanjing University, the Second Clinical College, Medical School of Southeast University, General Hospital of Eastern Theater Command, Nanjing 210002, China
Corresponding author: LI Wei-qin, E-mail: liweiqindr@vip.163.com 
Abstract    Omental sac necrsis rupture syndrome (OSNRS) is a special type of acute necrotic collection (ANC) in acute pancreatitis (AP), which is characterized by the accumulation of necrosis in the omental sac. With the progression of the disease, the scope of OSNRS will gradually expand and the pressure will gradually increase. Without active intervention, before it progresses to walled-off necrosis or infected pancreatic necrosis, the omental sac necrosis may break through the anterior wall of the omental sac (mainly through the gastrocolic ligament) into the peritoneal cavity, leading to acute peritonitis, multiple organ dysfunction, which is life-threatening. The diagnosis of OSARS mainly relies on two characteristic features of abdominal enhanced CT—transverse mesocolic invasion and omental sac necrosis spreading to the lateral hepatic region of the colon. The secondary complications include early spontaneous hemorrhage, colonic stenosis, obstruction, ischemia, necrosis, gallbladder gangrene and ischemia, portal venous system thrombosis, etc. Once diagnosed OSNRS, abdominal CT should be monitored closely and dynamically, and the timing of intervention should be determined according to the progression of the lesion. Percutaneous catheter drainage is recommended as the first choice for intervention.

Key words: acute pancreatitis, acute necrotic collection, Omental sac necrosis rupture syndrome