Hérin Edouard, Sauvanet Alain, Cros Jérome, Koulakian Hasmik, Lévy Philippe, Vullierme Marie Pierre
Department of Radiology, Beaujon Hospital, Clichy, France.
Department of Surgery, Beaujon Hospital, Clichy, France.
J Surg Case Rep. 2020 Aug 27;2020(8):rjaa175. doi: 10.1093/jscr/rjaa175. eCollection 2020 Aug.
We present a series of patients with recurrent acute pancreatitis caused by a duplicated pancreatic head connected to a gastric duplication and successfully treated by conservative surgery. This retrospective study included consecutive adult patients referred to our institution for recurrent acute pancreatitis. All patients underwent a preoperative non-invasive imaging examination including contrast-enhanced computed tomography and magnetic resonance cholangiopancreatography (MRCP). The final diagnosis of this developmental anomaly was based on surgical and pathological examinations. The four patients in this study had the same typical imaging pattern including a duplicated duct. There was no recurrent acute pancreatitis after surgical treatment, which involved atypical resection of the duplicated pancreatic head and segmental gastric resection, without a Whipple procedure. The discovery of an accessory pancreatic head with a duct terminating in a cyst identified on MRCP in a patient with recurrent acute pancreatitis could suggest this rare and surgically treatable cause of acute pancreatitis.
我们报告了一系列由与胃重复畸形相连的胰腺头部重复引起的复发性急性胰腺炎患者，并通过保守手术成功治疗。这项回顾性研究纳入了因复发性急性胰腺炎转诊至我院的连续成年患者。所有患者均接受了术前非侵入性影像学检查，包括增强计算机断层扫描和磁共振胰胆管造影（MRCP）。这种发育异常的最终诊断基于手术和病理检查。本研究中的4例患者具有相同的典型影像学表现，包括双管征。手术治疗包括对重复的胰腺头部进行非典型切除和节段性胃切除，未进行惠普尔手术，术后未再发生复发性急性胰腺炎。在复发性急性胰腺炎患者的MRCP上发现一个副胰头，其导管终止于一个囊肿，这可能提示这种罕见的、可手术治疗的急性胰腺炎病因。
