Li Zhuo-Ran, Cao Di, Li Juan, Yang Hong, Han Xian-Lin, Xue Hua-Dan, You Yan, Zhou Wei-Xun, Wu Dong, Qian Jia-Ming
Department of Gastroenterology, PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
Department of Radiology, PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2018 Jun 28;40(3):328-333. doi: 10.3881/j.issn.1000-503X.2018.03.005.
Objective To summarize the clinical features and outcomes of paraduodenal pancreatitis (PP). Methods Five clinically or pathologically diagnosed PP patients in Peking Union Medical College Hospital and 31 other PP cases reported in Chinese literature since 1988 were retrospectively analysed. Results Most PP patients were young or middle-aged males with a history of alcohol abuse. The clinical symptoms included upper abdominal pain,vomiting,weight loss,and fluctuating jaundice. Serum pancreatic enzymes were normal or elevated. Radiological features in most cases included thickening of the duodenal wall and duodenal stenosis (88.9%,32/36),cysts in the duodenal wall and groove area (47.2%,17/36),dilated bile duct (36.1%,13/36),and dilated pancreatic duct (16.7%,6/36). The main pathological finding was chronic pancreatitis,which could be accompanied by local acute inflammation,which was limited in the groove-duodenal area in most cases. The disease can be well controlled by conservative treatment,although surgery was needed in a small number of cases. Conclusion sPP typically occurs in young or middle-aged males. Radiological examination is valuable for diagnosis. Conservative treatment is the mainstream treatment in most patients.
目的 总结十二指肠旁胰腺炎(PP)的临床特征及治疗结果。方法 回顾性分析北京协和医院5例经临床或病理诊断的PP患者以及1988年以来中文文献报道的31例其他PP病例。结果 大多数PP患者为中青年男性,有酗酒史。临床症状包括上腹部疼痛、呕吐、体重减轻和波动性黄疸。血清胰酶正常或升高。大多数病例的影像学特征包括十二指肠壁增厚和十二指肠狭窄(88.9%,32/36)、十二指肠壁和沟区囊肿(47.2%,17/36)、胆管扩张(36.1%,13/36)和胰管扩张(16.7%,6/36)。主要病理表现为慢性胰腺炎,可伴有局部急性炎症,多数病例局限于沟-十二指肠区域。本病通过保守治疗可得到良好控制,少数病例需要手术治疗。结论 sPP通常发生于中青年男性。影像学检查对诊断有重要价值。保守治疗是大多数患者的主流治疗方法。