Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2010 Aug;26(8):448-55. doi: 10.1016/S1607-551X(10)70072-3.
In this report, we describe a 31-year-old man in whom acute pancreatitis was the initial feature of a subsequently diagnosed pancreatic adenocarcinoma with multiple metastases. He initially presented at our hospital with acute pancreatitis. Abdominal ultrasonography revealed a mildly dilated pancreatic duct and an enlarged pancreatic head. Although a follow-up abdominal ultrasonography revealed a progressively dilated pancreatic duct and a progressively enlarged pancreatic head, he refused further investigation and was lost to follow-up. Four months later, he returned to our hospital with relapsed acute pancreatitis. Obstructive jaundice was noted and drainage was performed. Because choledochoplasty with multiple balloon catheters was not fully effective, biliary tract bypass surgery was carried out. Intraoperative biopsy confirmed pancreatic adenocarcinoma with multiple metastases. The patient died of massive gastrointestinal bleeding a few weeks later. To our knowledge, this is the youngest case of pancreatic cancer with the uncommon initial presentation of acute pancreatitis reported in the literature. For a patient with acute pancreatitis, particularly recurrent episodes, but with no known risk factors for pancreatitis, a pancreatic neoplasm should be considered as a potential underlying cause, even in a young man.
在本报告中，我们描述了一名 31 岁男性，其急性胰腺炎是随后诊断为胰腺腺癌伴多发转移的首发特征。他最初因急性胰腺炎在我院就诊。腹部超声检查显示胰管轻度扩张和胰头增大。尽管后续的腹部超声检查显示胰管逐渐扩张和胰头逐渐增大，但他拒绝进一步检查并失访。四个月后，他因复发性急性胰腺炎再次回到我院。发现阻塞性黄疸并进行了引流。由于多次球囊导管胆管成形术效果不佳，进行了胆道旁路手术。术中活检证实为胰腺腺癌伴多发转移。数周后，患者因大量胃肠道出血死亡。据我们所知，这是文献中报道的首例以急性胰腺炎为首发表现且极为罕见的年轻胰腺癌病例。对于急性胰腺炎患者，特别是反复发作但无已知胰腺炎危险因素的患者，即使是年轻人，也应考虑胰腺肿瘤作为潜在的潜在病因。
