GROOVE PANCREATITIS MASQUERADING AS PANCREATIC-CARCINOMA
GROOVE PANCREATITIS MASQUERADING AS PANCREATIC-CARCINOMA
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DOI：
10.1016/0002-9610(92)90009-g
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发表时间：
1992-03-01
影响因子：
3
通讯作者：
TANAKA, M
中科院分区：
文献类型：
--
作者：
YAMAGUCHI, K;TANAKA, M
本文回顾八位日本患者的临床病理及影像学特徴。 所有患者均为男性，平均年龄58岁。 三名病人主诉腹痛，而其他人有黄疸。 1例患者黄疸波动。 4名患者多次发生胰腺炎，4名患者为酗酒者。 影像学上，十二指肠狭窄在5例患者中是明显的，胆管狭窄在6例，胰管狭窄在4例，并在6胰头肿块。 胆管狭窄的特点是光滑的锥形，改善后，在3例胆道引流。 在接受血管造影术的4名患者中，2名显示血管包绕，1名显示血管丰富的肿块，另1名无异常。 所有患者均因疑似胰腺癌行胰管切除术。 然而，组织病理学诊断为慢性胰腺炎，局限于胆总管远端、十二指肠和胰腺之间的沟。 十二指肠出现疤痕和布伦纳腺增生。 胆道狭窄是由胆总管远端周围的纤维化和慢性炎症引起的。 沟型胰腺炎的临床表现多样，如胆道梗阻、十二指肠狭窄、胰腺肿块等，常以胰头癌为伪装。 在诊断胰头癌时应注意这一情况，以避免不必要的根治性手术。
The clinicopathologic and radiologic features of groove pancreatitis masquerading as pancreatic carcinoma in eight Japanese patients were reviewed. All patients were men with a mean age of 58 years. Three patients complained of abdominal pain whereas others had jaundice. The jaundice fluctuated in one patient. Four patients had several episodes of pancreatitis, and four patients were alcoholics. Radiologically, a duodenal stricture was evident in five patients, biliary stenosis in six, pancreatic duct stenosis in four, and a mass in the pancretic head in six. The biliary stenosis was characterized by smooth tapering, which improved after biliary drainage in three cases. Of the four patients who underwent angiography, two showed an encasement of vessels, one a hypervascular mass, and the other no abnormality. All patients underwent a pancreatoduodenectomy for suspected pancreatic carcinoma. However, the histopathologic diagnosis was chronic pancreatitis confined to the groove between the distal common bile duct, duodenum, and pancreas. The duodenum showed scarring and hyperplasia of the Brunner's gland. The biliary stenosis was produced by fibrosis and chronic inflammation around the distal common bile duct. Groove pancreatitis presents various clinical features, such as biliary obstruction, duodenal stenosis, and pancreatic mass, and often masquerades as pancreatic head carcinoma. This condition should be kept in mind when making a diagnosis of pancreatic head carcinoma to avoid an unnecessary radical operation.