Simon Remil, Zoog Evon, Philips George, Dowden Jacob
Department of Surgery, University of Tennessee College of Medicine at Chattanooga, Chattanooga, TN.
Department of Medicine, Division of Gastroenterology, University of Tennessee College of Medicine at Chattanooga, Chattanooga, TN.
ACG Case Rep J. 2017 Dec 6;4:e123. doi: 10.14309/crj.2017.123. eCollection 2017.
Intrapancreatic enteric duplication cysts are exceedingly rare, and the clinical presentation varies. We present a 48-year-old man with significant alcohol and tobacco abuse and a diagnosis of groove pancreatitis complicated by a pancreatic duct stricture, pseudocyst, and recurrent biliary obstruction. Due to failure of endoscopic therapy and concerning findings on endoscopic ultrasound with negative pathology, he underwent a pancreaticoduodenectomy. Pathology revealed an intrapancreatic enteric duplication cyst, minimal chronic pancreatitis changes associated with pancreaticobiliary strictures, and no evidence of malignancy. This rare diagnosis should be considered in the differential for patients with idiopathic recurrent pancreaticobiliary duct strictures and pancreatic pseudomasses.
胰腺内肠源性重复囊肿极为罕见,临床表现各异。我们报告一例48岁男性,有大量酗酒和吸烟史,诊断为沟部胰腺炎,并发胰管狭窄、假性囊肿和复发性胆管梗阻。由于内镜治疗失败且内镜超声检查结果令人担忧而病理检查为阴性,他接受了胰十二指肠切除术。病理显示为胰腺内肠源性重复囊肿,伴有胰胆管狭窄的轻度慢性胰腺炎改变,且无恶性证据。对于特发性复发性胰胆管狭窄和胰腺假性肿块患者的鉴别诊断中应考虑这种罕见的诊断。