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重症急性胰腺炎愈合期的炎性胆管梗阻

Inflammatory Bile Duct Obstruction during the Healing Stage of Severe Acute Pancreatitis.

作者信息

Yamabe Akane, Irisawa Atsushi, Shibukawa Goro, Sato Ai, Fujisawa Mariko, Arakawa Noriyuki, Yoshida Yoshitsugu, Igarashi Ryo, Maki Takumi, Yamamoto Shogo, Ikeda Tsunehiko, Abe Yoko, Hoshi Koki

机构信息

Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Japan.

出版信息

Intern Med. 2017;56(9):1037-1040. doi: 10.2169/internalmedicine.56.7859. Epub 2017 May 1.

DOI:10.2169/internalmedicine.56.7859
PMID:28458308
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5478563/
Abstract

The patient was a 62-year-old woman with a history of severe acute pancreatitis complicated by walled-off necrosis (WON), who developed obstructive jaundice during the recovery phase from WON. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) revealed the complete obstruction of the distal bile duct, and endoscopic ultrasonography (EUS) revealed thickening of the duct wall, with a uniform distribution, and a relatively well-preserved layered structure. A cytopathological examination using ERCP showed no malignancy. The underlying etiology of this case may have been the formation of a cicatricial stricture during the resolution of WON, in addition to fibrosis caused by the spreading of inflammation from pancreatitis.

摘要

该患者为一名62岁女性，有严重急性胰腺炎病史并伴有包裹性坏死（WON），在WON恢复阶段出现梗阻性黄疸。磁共振胰胆管造影（MRCP）和内镜逆行胰胆管造影（ERCP）显示远端胆管完全梗阻，内镜超声检查（EUS）显示胆管壁增厚，分布均匀，分层结构相对保存完好。ERCP进行的细胞病理学检查未发现恶性病变。该病例的潜在病因可能是WON消退过程中形成瘢痕性狭窄，此外还有胰腺炎炎症扩散导致的纤维化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b189/5478563/e0c41f692d57/1349-7235-56-1037-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b189/5478563/d42859009430/1349-7235-56-1037-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b189/5478563/25be60dd2e0b/1349-7235-56-1037-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b189/5478563/8e3b22480652/1349-7235-56-1037-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b189/5478563/72e219761c87/1349-7235-56-1037-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b189/5478563/e0c41f692d57/1349-7235-56-1037-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b189/5478563/d42859009430/1349-7235-56-1037-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b189/5478563/25be60dd2e0b/1349-7235-56-1037-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b189/5478563/8e3b22480652/1349-7235-56-1037-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b189/5478563/72e219761c87/1349-7235-56-1037-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b189/5478563/e0c41f692d57/1349-7235-56-1037-g005.jpg

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