Yang Ryan C, Abuhakmeh Yousef, Schriver John P, Nelson Daniel W
Department of General Surgery, William Beaumont Army Medical Center, El Paso, TX, USA.
J Surg Case Rep. 2021 Jun 22;2021(6):rjab270. doi: 10.1093/jscr/rjab270. eCollection 2021 Jun.
A young adult male presented with recurrent pancreatitis and a 2.2 cm mixed duct intraductal papillary mucinous neoplasm (IPMN) located in the pancreatic body. Our patient presented at age 21 with his second hospitalization for acute pancreatitis within a year. A mixed duct IPMN with main ductal dilation was identified, which prompted additional workup. Based upon the findings the patient was counseled regarding the risks and benefits of surveillance versus surgery. The patient elected to undergo a robotic-assisted laparoscopic distal pancreatectomy and splenectomy. Final pathology revealed an IPMN involving branch and main pancreatic ducts with low and focally high-grade dysplasia. IPMNs are increasingly being identified. Consensus guidelines generally propose surveillance, but management in young adults can be complex. Herein we present the second youngest reported case and highlight the continued need for consensus management guidelines.
一名年轻成年男性出现复发性胰腺炎,胰腺体部有一个2.2厘米的混合导管内乳头状黏液性肿瘤(IPMN)。我们的患者21岁时因急性胰腺炎在一年内第二次住院。发现了一个伴有主胰管扩张的混合导管IPMN,这促使进行了进一步检查。根据检查结果,向患者咨询了监测与手术的风险和益处。患者选择接受机器人辅助腹腔镜远端胰腺切除术和脾切除术。最终病理显示IPMN累及分支胰管和主胰管,伴有低级别和局灶性高级别发育异常。IPMN越来越多地被发现。共识指南通常建议进行监测,但年轻成年人的管理可能很复杂。在此,我们报告了第二例年龄最小的病例,并强调了持续需要达成共识的管理指南。