Iwatsuka Kunio, Nakagawara Hiroshi, Ogawa Masahiro, Gotoda Takuji, Hayashi Shigeoki, Kinukawa Noriko, Hemmi Akihiro, Yamao Kenji, Yanagisawa Akio, Moriyama Mitsuhiko
Division of Gastroenterology and Hepatology, Nihon University School of Medicine, Japan.
Department of Digestive Surgery, Nihon University School of Medicine, Japan.
Intern Med. 2018 May 1;57(9):1241-1245. doi: 10.2169/internalmedicine.9862-17. Epub 2017 Dec 27.
A 68-year-old man with a history of diabetes mellitus was admitted to our hospital with a diagnosis of acute pancreatitis. Abdominal computed tomography revealed a suspicious tumor in the body of the pancreas, along with a dilated main pancreatic duct and edema of the pancreatic tail. Endoscopic retrograde pancreatography was performed after treating the patient's pancreatitis. When a cannula tip was advanced beyond the stenosis, deep into the distal pancreatic duct, thick white pus was evacuated. A bacteriological examination of the aspirated pancreatic juice revealed Enterobacter cloacae, and a cytological examination revealed adenocarcinoma. The diagnosis was acute obstructive suppurative pancreatic ductitis associated with pancreatic carcinoma.
一名68岁的男性糖尿病患者因急性胰腺炎入院。腹部计算机断层扫描显示胰腺体部有一个可疑肿瘤,同时主胰管扩张,胰尾水肿。在治疗患者的胰腺炎后进行了内镜逆行胰胆管造影。当插管尖端越过狭窄部位,深入胰管远端时,引出了浓稠的白色脓液。对吸出的胰液进行细菌学检查发现阴沟肠杆菌,细胞学检查发现腺癌。诊断为与胰腺癌相关的急性梗阻性化脓性胰管炎。