Palitzsch K D, Back W, Raute M, Georgi M, Bode H, Usadel K H
II. Medizinische Klinik, Universität Heidelberg.
Dtsch Med Wochenschr. 1990 Mar 30;115(13):496-500. doi: 10.1055/s-2008-1065037.
A 48-year-old woman complained of right-sided upper abdominal pain and recurrent vomiting, and had lost 10 kg in 4 months. Ultrasound and computed tomography showed a solid, space-occupying lesion in the head of the pancreas, not separable from the duodenum. Despite thorough investigation the nature of the lesion remained obscure. Operation revealed a divided pancreas with stenosis of the accessory duct at the papilla. Histological examination showed pseudosarcomatous myofibroblastic proliferation within the duodenal wall in the vicinity of a duodenal wall cyst which had been destroyed by inflammation. In cases of divided pancreas it is the accessory duct which drains the main bulk of the pancreas, while the main duct carries little or no secretion; the stenosis of the accessory duct in this patient had therefore led to low-grade pancreatitis involving the head of the pancreas.
一名48岁女性主诉右上腹疼痛并反复呕吐，4个月内体重减轻了10千克。超声和计算机断层扫描显示胰腺头部有一个实性占位性病变，与十二指肠无法分离。尽管进行了全面检查，病变的性质仍不明确。手术发现胰腺分裂，副胰管在乳头处狭窄。组织学检查显示，在十二指肠壁囊肿附近的十二指肠壁内有假肉瘤性肌纤维母细胞增生，该囊肿已被炎症破坏。在胰腺分裂的病例中，是副胰管引流胰腺的主要部分，而主胰管分泌很少或不分泌；因此，该患者副胰管狭窄导致了累及胰腺头部的轻度胰腺炎。
