Duodenal Pancreatic Heterotopy Diagnosed by Magnetic Resonance Cholangiopancreatography: Report of a Case
Duodenal Pancreatic Heterotopy Diagnosed by Magnetic Resonance Cholangiopancreatography: Report of a Case
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DOI：
10.1007/s005950170038
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发表时间：
2001-10
期刊：
影响因子：
2.5
通讯作者：
M. Indinnimeo;C. Cicchini;A. Stazi;C. Ghini;A. Laghi;L. Memeo;R. Iannaccone;F. Teneriello;P. Mingazzini
中科院分区：
文献类型：
--
作者：
M. Indinnimeo;C. Cicchini;A. Stazi;C. Ghini;A. Laghi;L. Memeo;R. Iannaccone;F. Teneriello;P. Mingazzini
我们在此描述的情况下，异位胰腺造成狭窄的第二部分十二指肠。一位46岁男性，因上腹部疼痛和12个月的间歇性呕吐病史就诊。没有黑便、便血、呕血、粘土色粪便、黄疸或肝炎病史，他也没有描述任何食物恶液质，尽管脂肪食物和酒精似乎使症状加重。没有特定的药物或位置的变化缓解了疼痛。根据血清淀粉酶和脂肪酶水平升高以及腹部超声和计算机断层扫描（CT）结果，初步诊断为慢性胰腺炎伴多发性假性囊肿。给予奥曲肽治疗8周，但无任何明显效果。双对比钡剂检查和食管胃管镜检查不能诊断。磁共振（MR）胰胆管造影显示结果表明异位胰腺囊性营养不良（CDHP），内镜检查支持这一诊断。病理检查证实诊断为CDHP。我们认为，当怀疑CDHP时，MR胰胆管造影是首选的诊断工具。
We describe herein the case of a heterotopic pancreas that caused stenosis in the second portion of the duodenum. A 46-year-old man presented with upper abdominal pain and a 12-month history of intermittent vomiting. There was no history of melena, hematochezia, hematemesis, clay-colored stools, jaundice, or hepatitis and he did not describe any food dyscrasias, although fatty foods and alcohol seemed to make the symptoms worse. No specific medication or change in position relieved the pain. An initial diagnosis of chronic pancreatitis with multiple pseudocysts was made on the basis of elevated serum amylase and lipase levels, and abdominal ultrasonography and computed tomography (CT) findings. Medical treatment with octreotide was given for 8 weeks, but without any marked effect. Double-contrast barium examination and esophagogastroduodenoscopy were not diagnostic. Magnetic resonance (MR) cholangiopancreatography revealed findings indicative of cystic dystrophy of a heterotopic pancreas (CDHP), and an endoscopy supported this diagnosis. A pancreatoduodenectomy was performed and pathological examination confirmed a diagnosis of CDHP. In our opinion, MR cholangiopancreatography is the diagnostic tool of choice when CDHP is suspected.