Rousek Michael, Kachlik David, Nikov Andrej, Pintova Jirina, Ryska Miroslav
Department of Surgery, 2 Faculty of Medicine, Charles University and Central Military Hospital, Prague 16002, Czech Republic.
Department of Anatomy, 2 Faculty of Medicine, Charles University, Prague 15006, Czech Republic.
World J Clin Cases. 2018 Dec 26;6(16):1182-1188. doi: 10.12998/wjcc.v6.i16.1182.
The combination of a gastric duplication cyst and duplicated part of the pancreas is an extremely rare developmental defect. The incidence in the population, or the clinical impact thereof, has not been uncovered. Symptoms are unspecific. Surgery is the treatment of choice. Timely diagnostics are of utmost importance, albeit they might be challenging at times. Being so rare, case reports are currently the only relevant source of information about the condition. Therefore each published finding is of a clinical impact.
Our work describes the case of a 22 year-old patient, who developed idiopathic acute pancreatitis. A computed tomography scan discovered liquid collection between the antrum of the stomach and the head of the pancreas. Initially, the collection was thought to be a pancreatic pseudocyst. Endoscopic ultrasound-guided transgastric drainage showed to have only a temporary therapeutic effect. Magnetic resonance cholangiopancreatography showed an accessory pancreatic lobe with a separate duct system. The accessory pancreatic lobe exited the body of the pancreas and was in contact with the cystic collection. The patient was indicated for surgical resection. Within the surgery, an resection of the accessory pancreatic lobe was performed with the antrum of the stomach containing the gastric duplication cyst. No complications were observed in the surgery or thereafter. In the five months follow-up period, the patient was completely symptom free. Histopathological findings confirmed the gastric duplication cyst communicating to accessory pancreatic lobe.
This developmental defect is extremely rare. It can cause recurrent acute pancreatitis. Diagnostics are challenging. Surgery is treatment of choice.
胃重复囊肿与胰腺重复部分的组合是一种极其罕见的发育缺陷。尚未发现其在人群中的发病率或临床影响。症状不具有特异性。手术是首选治疗方法。及时诊断至关重要，尽管有时可能具有挑战性。由于这种情况非常罕见，病例报告目前是有关该病症的唯一相关信息来源。因此，每一项已发表的发现都具有临床意义。
我们的研究描述了一名22岁特发性急性胰腺炎患者的病例。计算机断层扫描发现胃窦和胰头之间有液体积聚。最初，该液体积聚被认为是胰腺假性囊肿。内镜超声引导下经胃引流显示仅具有暂时的治疗效果。磁共振胰胆管造影显示一个副胰叶，有一个独立的导管系统。副胰叶从胰腺主体发出，并与囊性积液接触。该患者被建议进行手术切除。手术中，切除了包含胃重复囊肿的胃窦及副胰叶。手术期间及之后均未观察到并发症。在五个月的随访期内，患者完全没有症状。组织病理学检查结果证实胃重复囊肿与副胰叶相通。
这种发育缺陷极其罕见。它可导致复发性急性胰腺炎。诊断具有挑战性。手术是首选治疗方法。
