胰腺黏液性囊性肿瘤伴发急性胰腺炎。
Mucinous cystic tumour of the pancreas presenting with acute pancreatitis.
机构信息
Department of Surgical and Clinical Sciences (Surgery), University of Edinburgh, Royal Infirmary of Edinburgh, UK.
出版信息
HPB (Oxford). 2001;3(4):271-3. doi: 10.1080/136518201753335782.
BACKGROUND
The optimal therapy for mucinous neoplasms of the pancreas is surgical resection because these tumours are either premalignant (cystadenoma) or malignant.
CASE OUTLINE
A 44-year-old previously fit woman presented with sudden onset of epigastric pain. Clinical and laboratory findings were consistent with acute pancreatitis. Abdominal ultrasound scan demonstrated a mature 6-cm cyst in the tail of pancreas and no findings suggestive of cholelithiasis. These findings were confirmed by a CT scan, which also demonstrated splenic infarction and evidence of recent haemorrhage into the cyst. The patient's abdominal pain persisted after amylase levels returned to normal.
RESULTS
Splenic infarction, a mature cyst in the tail of the pancreas, and peripancreatic inflammation consistent with recent pancreatitis were found at laparotomy. Enbloc distal pancreatectomy and splenectomy were performed. Histological examination of the cyst wall demonstrated a focus of mucinous cystadenoma.
DISCUSSION
This case demonstrates that acute pancreatitis may be the first presentation of a cystic neoplasm.
背景
胰腺黏液性肿瘤最佳的治疗方法是手术切除，因为这些肿瘤要么是癌前病变（囊腺瘤），要么是恶性的。
病例概述
一位 44 岁既往健康的女性突发上腹痛。临床和实验室检查结果符合急性胰腺炎。腹部超声检查显示胰腺尾部有一个成熟的 6cm 囊肿，没有提示胆石症的发现。这些发现通过 CT 扫描得到了证实，CT 扫描还显示脾梗死和囊肿内近期出血的证据。淀粉酶水平恢复正常后，患者的腹痛仍持续存在。
结果
剖腹探查时发现脾梗死、胰腺尾部的成熟囊肿以及符合近期胰腺炎的胰周炎症。行整块胰尾切除术和脾切除术。囊肿壁的组织学检查显示有一处黏液性囊腺瘤。
讨论
本例表明，急性胰腺炎可能是囊性肿瘤的首发表现。
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