大量胰腺胸膜腔积液：胰管破裂的发病机制
Massive pancreatic pleural effusion: pathogenesis of pancreatic duct disruption.
作者信息
Semba D, Wada Y, Ishihara Y, Kaji T, Kuroda A, Morioka Y
机构信息
First Surgical Department, University of Tokyo, Japan.
出版信息
Gastroenterology. 1990 Aug;99(2):528-32. doi: 10.1016/0016-5085(90)91037-7.
Massive pancreatic pleural effusion is believed to be caused by pancreatic duct disruption. To elucidate the cause of the duct disruption, pancreas specimens resected from three cases of massive pancreatic pleural effusion were investigated histopathologically. There was no evidence of either chronic or acute pancreatitis except focal fibrosis along a single dilated duct in the resected pancreas. From our study, the pathogenesis of pancreatic duct disruption is suggested as follows: (a) alcohol ingestion can induce focal acute inflammation on a single branch of the duct system and elicit protein plug formation; and (b) focal stenotic change occurs on this branch at a point near the main pancreatic duct, and transient obstruction can occur by means of the protein plugs. The "upstream" extent of this branch will then dilate until it ruptures. However, on the frequency of this atypical pancreatitis, we have no clues to mention.
大量胰源性胸腔积液被认为是由胰管破裂引起的。为了阐明胰管破裂的原因，对3例大量胰源性胸腔积液患者切除的胰腺标本进行了组织病理学研究。除了切除的胰腺中沿单一扩张导管的局灶性纤维化外，没有慢性或急性胰腺炎的证据。根据我们的研究，胰管破裂的发病机制如下：(a) 酒精摄入可在导管系统的单个分支上诱发局灶性急性炎症并引发蛋白栓形成；(b) 该分支在靠近主胰管的一点处发生局灶性狭窄改变，蛋白栓可导致短暂性梗阻。然后该分支的“上游”部分会扩张直至破裂。然而，关于这种非典型胰腺炎的发生率，我们尚无线索可提。
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