Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007, Shimo-Nagakubo, Sunto-Nagaizumi, Shizuoka, 411-8777, Japan.
Surg Today. 2012 Aug;42(8):805-7. doi: 10.1007/s00595-012-0154-4. Epub 2012 Mar 6.
An intramural pseudocyst in the alimentary tract develops as a rare complication of acute pancreatitis or trauma. A 60-year-old woman with pancreatic head cancer underwent preoperative radiological examinations, which revealed a 45-mm cystic mass around the second portion of the duodenum. Endoscopic ultrasonography confirmed a cystic lesion in the submucosal layer of the duodenum and fine needle aspiration cytology of the cystic contents suggested adenocarcinoma. The cystic fluid was amylase-rich, at 17040 U/l. We performed pancreaticoduodenectomy for the pancreatic head cancer. Pancreatography of the resected specimen showed a communication between the main pancreatic duct and the cystic lesion. The cut surface of the resected specimen revealed a cystic lesion, which surrounded the duodenum. Pathologically, the cystic lesion was diagnosed as a pseudocyst, located between the dissociated smooth muscle layers of the duodenum.
消化道壁内假性囊肿是急性胰腺炎或外伤的罕见并发症。一位 60 岁女性因胰头癌接受术前影像学检查，发现十二指肠第二段周围有一个 45 毫米的囊性肿块。内镜超声检查证实十二指肠黏膜下层有囊性病变，囊性内容物的细针抽吸细胞学检查提示腺癌。囊性液中富含淀粉酶，为 17040 U/L。我们为该胰头癌患者施行胰十二指肠切除术。切除标本的胰造影显示主胰管与囊性病变之间有相通。切除标本的切面显示有一个囊性病变，环绕十二指肠。病理检查显示，囊性病变被诊断为假性囊肿，位于分离的十二指肠平滑肌层之间。
