Rockx Marie-Antoinette J, McAlister Vivian C
Department of Medicine, London Health Sciences Centre, London, Canada.
JOP. 2007 Nov 9;8(6):795-8.
Non-invasive tools such as endoscopic ultrasound and magnetic resonance cholangiopancreatography have assisted the diagnosis of unexplained or recurrent acute pancreatitis prior to endoscopic retrograde cholangiopancreatography (ERCP). The majority of these patients are improved by endoscopic therapy with ERCP. Duodenal duplication cyst is a known but rare cause of recurrent acute pancreatitis that is also amenable to ERCP. We document the diagnosis and treatment of a 26-year-old man who had six episodes of pancreatitis that were found to be due to a duodenal duplication cyst. The pancreatico-biliary tree emptied into the cyst, which caused episodic obstruction and reflux contaminated juice resulting in pancreatitis. The patient also complained of persistent epigastric discomfort between attacks. Video demonstration of the technique for fenestration of the cyst is presented. Free emptying of bile and pancreatic juice from the cyst has resulted in elimination of the patient's persistent epigastric discomfort and attacks of pancreatitis.
诸如内镜超声和磁共振胰胆管造影等非侵入性工具在内镜逆行胰胆管造影（ERCP）之前辅助诊断不明原因或复发性急性胰腺炎。这些患者中的大多数通过ERCP内镜治疗得到改善。十二指肠重复囊肿是复发性急性胰腺炎的一种已知但罕见的病因，也适合ERCP治疗。我们记录了一名26岁男性的诊断和治疗过程，该患者发生了6次胰腺炎发作，发现是由十二指肠重复囊肿引起的。胰胆管树排入囊肿，导致间歇性梗阻和反流受污染的胰液，从而引发胰腺炎。患者在发作间歇期还主诉上腹部持续不适。本文展示了囊肿开窗术的视频演示。囊肿内胆汁和胰液的自由排空消除了患者上腹部的持续不适和胰腺炎发作。
