Jausset F, Delvaux M, Dumitriu D, Bressenot A, Bruot O, Mathias J, Regent D, Laurent V
Department of Adults Radiology, University Brabois Hospital, Vandoeuvre les Nancy, France.
Digestion. 2010;82(1):42-6. doi: 10.1159/000265829. Epub 2010 Mar 4.
Invasive intraductal papillary-mucinous neoplasms (IPMNs) of the pancreas may be associated with pancreaticogastric fistulas as shown by case reports. We report the case of a benign IPMN associated with pancreaticogastric and pancreaticoduodenal fistulas. A 70-year-old woman was admitted with intestinal obstruction. Computed tomography and MRI showed a large dilatation of the main pancreatic duct (>1 cm) with intraductal nodules, and pancreaticogastric and pancreaticoduodenal fistulas. Several features in imaging were present to support a malignant IPMN, so that the patient underwent a pancreaticoduodenectomy. The histopathological examination of the surgical specimen showed a benign IPMN. This case proves that a benign IPMN can cause pancreaticogastric and pancreaticoduodenal fistulas, probably resulting from mechanical factors.
胰腺导管内乳头状黏液性肿瘤（IPMN）的侵袭性病例报告显示，其可能与胰胃瘘有关。我们报告了1例伴有胰胃瘘和胰十二指肠瘘的良性IPMN病例。1名70岁女性因肠梗阻入院。计算机断层扫描和磁共振成像显示主胰管显著扩张（>1 cm），伴有导管内结节以及胰胃瘘和胰十二指肠瘘。影像学上有几个特征支持恶性IPMN的诊断，因此该患者接受了胰十二指肠切除术。手术标本的组织病理学检查显示为良性IPMN。该病例证明，良性IPMN可导致胰胃瘘和胰十二指肠瘘，可能是由机械因素引起的。
