Leder G, Formentini A, Hoffmann M, Henne-Bruns D
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universität Ulm, Steinhövelstrabe 9, 89075, Ulm.
Chirurg. 2008 Mar;79(3):252-7. doi: 10.1007/s00104-007-1415-4.
Necrotising pancreatitis may develop as a consequence of pancreatic duct obstruction by stones, tumors or in the presence of a pancreas divisum. Alcohol and nicotine are regarded as risk factors for the disease becoming chronic.
A 63-year-old female patient with suspected cystadenocarcinoma of the pancreas tail, which was resolved as a pancreatic pseudocyst, was treated for recurrent pancreatitis for 2 years. A tumor in the pancreas head was only detected on a follow-up CT after resection of a complicating liver abscess. In retrospect, progressive pancreatic duct anomalies were visible on previous scans. Partial duodenopancreatectomy confirmed the presence of a pancreas head carcinoma.
Continuous critical re-evaluation of all potential causes of pancreatitis including rare conditions, such as a tumor, is required particularly if pancreatitis recurs over a long period. Re-evaluation of studies over time and of findings apart from the actual main focus of the complication, in this case pancreatitis of the pancreas tail, may help to detect the underlying disease instead of just treating the consequences.
坏死性胰腺炎可能由于结石、肿瘤导致胰管梗阻或存在胰腺分裂而发生。酒精和尼古丁被视为该疾病转为慢性的危险因素。
一名63岁女性患者,怀疑胰尾有囊腺癌,后诊断为胰腺假性囊肿,因复发性胰腺炎接受了2年治疗。在切除一个并发的肝脓肿后的随访CT检查中才发现胰头有肿瘤。回顾既往扫描,可见胰管有进行性异常。十二指肠胰头部分切除术证实存在胰头癌。
对于胰腺炎的所有潜在病因,包括肿瘤等罕见情况,需要持续进行严格的重新评估,尤其是当胰腺炎长期复发时。随着时间的推移重新评估各项检查以及除并发症实际主要关注点(在本例中为胰尾胰腺炎)之外的检查结果,可能有助于发现潜在疾病,而不仅仅是治疗其后果。