Colović Radoje, Grubor Nikica, Micev Marjan, Perisić Mirjana, Latincić Stojan, Colović Natasa
School of Medicine, University of Belgrade, Belgrade, Serbia.
Clinic of Digestive Surgery, First Surgical Clinic, Clinical Center of Serbia, Belgrade, Serbia.
Srp Arh Celok Lek. 2013 Sep-Oct;141(9-10):680-4. doi: 10.2298/sarh1310680c.
Cystic dystrophy of the duodenal wall is a rare complication of the ectopic pancreas that is characterized by cyst/s formation within thickened duodenal wall.
A 61-year-old male with recurrent abdominal pain, weight loss (about 25 kg) who had been moderate alcohol abuser and heavy smoker was presented. On ultrasonography, very thickened duodenal wall (2.5 cm), an enlarged head of the pancreas with cyst of 3 cm in diameter as well as dilated pancreatic duct (< 6 mm) were seen. Barium meal showed stenosis of the first and second part of the duodenum. CT and endoscopic ultrasound confirmed the ultrasonographic finding.The patient underwent surgery. The pathologic finding was established only on first two portions of the duodenum and limited part of the head of the pancreas along duodenum while the rest of the pancreas was normal. Due to poor general condition, gastrojejunostomy was performed. Although some improvement was evident, the patient did not become asymptomatic, and, therefore, four months later a cephalic duodenopancreatectomy was carried out which made him fully asymptomatic. A year later, the patient was symptom-free and in good health. Histologic examination showed a cystic dystrophy of the duodenal wall in the ectopic pancreas.
Unless there are strong contraindications, cephalic duodenopancreatectomy is best treatment of the disease.
十二指肠壁囊肿性营养不良是异位胰腺的一种罕见并发症，其特征是在增厚的十二指肠壁内形成囊肿。
一名61岁男性，有反复腹痛、体重减轻（约25千克），曾是中度酗酒者和重度吸烟者。超声检查发现十二指肠壁非常增厚（2.5厘米），胰腺头部肿大，有一个直径3厘米的囊肿，以及扩张的胰管（<6毫米）。钡餐显示十二指肠第一部和第二部狭窄。CT和内镜超声证实了超声检查结果。患者接受了手术。病理检查仅在十二指肠的前两部分以及沿十二指肠的胰腺头部有限部分发现病变，而胰腺的其余部分正常。由于全身状况较差，进行了胃空肠吻合术。虽然有明显改善，但患者仍有症状，因此，四个月后进行了胰头十二指肠切除术，术后患者完全无症状。一年后，患者无症状且健康状况良好。组织学检查显示异位胰腺存在十二指肠壁囊肿性营养不良。
除非有强烈的禁忌症，胰头十二指肠切除术是该病的最佳治疗方法。
