Yamazaki Tomoo, Ochi Yasuhide, Tanaka Naoki, Watanabe Takayuki, Iwaya Yugo, Seki Ayako, Hara Etsuo, Tanaka Eiji, Watanabe Tomoharu, Imai Shun, Hasebe Osamu
Department of Gastroenterology, Nagano Municipal Hospital, Nagano, Japan.
Department of Internal Medicine, Division of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan.
Clin J Gastroenterol. 2017 Feb;10(1):73-78. doi: 10.1007/s12328-016-0702-3. Epub 2016 Dec 10.
An 86-year-old man with a long-term habit of ethanol consumption was admitted due to massive transudate ascites and leg edema. Abdominal computed tomography revealed a dilated main pancreatic duct and atrophied pancreatic parenchyma, leading to the diagnosis of chronic pancreatitis. Moreover, the portal vein was enhanced in the early arterial phase, which indicated the presence of an arterioportal fistula. The fistula was located between the posterior superior pancreaticoduodenal artery and the portal vein near a pancreatic retention cyst. Transarterial coil embolization dramatically improved the ascites. Arterioportal fistula and ensuing ascites should be recognized as a complication of chronic pancreatitis.
一名有长期饮酒习惯的86岁男性因大量漏出液性腹水和腿部水肿入院。腹部计算机断层扫描显示主胰管扩张和胰腺实质萎缩，从而诊断为慢性胰腺炎。此外，门静脉在动脉早期强化，提示存在动脉门静脉瘘。瘘位于胰十二指肠后上动脉与胰腺潴留囊肿附近的门静脉之间。经动脉线圈栓塞术显著改善了腹水。动脉门静脉瘘及随之而来的腹水应被视为慢性胰腺炎的一种并发症。
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