Segmental groove pancreatitis accompanied by protein plugs in Santorini's duct
Segmental groove pancreatitis accompanied by protein plugs in Santorini's duct
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DOI：
10.1007/s005350050086
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发表时间：
1998-04-01
影响因子：
6.3
通讯作者：
Kohgo, Y
中科院分区：
文献类型：
--
作者：
Shudo, R;Obara, T;Kohgo, Y
“沟型胰腺炎”是一种影响胰头的节段性胰腺炎，位于胰头、十二指肠和胆总管之间的“沟”内。沟型胰腺炎和胰头癌的鉴别常常很困难。我们报告一个沟型胰脏炎的病例，影像显示十二指肠壁与胰脏间有一低回声肿块，并同时发现十二指肠第二段狭窄及胆管狭窄，最后经手术（保留幽门的胰脏切除术）证实。患者术后腹痛缓解。到目前为止，病人的情况一直很好。我们回顾了日本文献中沟型胰腺炎的临床病理和影像学特征，并讨论了圣托里尼管在其发病机制中的可能作用。我们认为，在圣托里尼管的蛋白质塞的影响是一个致病因素，在沟胰腺炎的发展。因此，Santorini管的内镜逆行胰管造影表现对沟型胰腺炎的诊断具有重要意义。沟型胰腺炎的临床表现多样，如胆管狭窄、十二指肠狭窄、胰腺肿块等，常以胰头癌为伪装。在胰头癌的鉴别诊断中应注意这一情况。
"Groove pancreatitis", a form of segmental pancreatitis affecting the head of the pancreas, is localized within the "groove" between pancreas head, duodenum, and common bile duct. Differentiation between groove pancreatitis and pancreatic head carcinoma is often difficult. We report a case of groove pancreatitis in which a hypoechoic mass between the duodenal wall and pancreas was clearly imaged, and narrowing of the second portion of the duodenum and bile duct stenosis were also found. The diagnosis was confirmed by surgery (pylorus-preserving pancreato duodenectomy). The patient was relieved from abdominal pain post operation. Up to the present, the patient has been good condition. We review the clinicopathologic and radiologic features of groove pancreatitis in the Japanese literature and discuss the possible role of Santorini's duct in its pathogenesis. We consider that impacted protein plugs in Santorini's duct are a pathogenic factor in the development of groove pancreatitis. Therefore, the findings of Santorini's duct on endoscopic retrograde pancreatography are very important in the diagnosis of groove pancreatitis. Groove pancreatitis presents various clinical features, such as biliary stenosis, duodenal stenosis, and pancreatic mass, and often masquerades as pancreatic head carcinoma. This condition should be kept in mind in the differential diagnosis of pancreatic head carcinoma.