Rivai M Iqbal, Mitra Juni, Suchitra Avit, Suswita Rini, Janer Aulia, Tantyo Edo B
Division of Digestive Surgery, Department of Surgery, Faculty of Medicine Andalas University - M.Djamil General Hospital, West Sumatera, 25171, Indonesia.
General Surgery Resident, Faculty of Medicine, Andalas University - M. Djamil General Hospital, West Sumatera, 25171, Indonesia.
Ann Med Surg (Lond). 2021 Oct 14;71:102947. doi: 10.1016/j.amsu.2021.102947. eCollection 2021 Nov.
BACKGROUND/OBJECTIVE: Tropical chronic pancreatitis (TCP) is common in developing countries and is defined as a juvenile form of chronic calcific non-alcoholic pancreatitis. Pseudocysts occur in 20-40% of chronic pancreatitis. TCP with pseudocyst has not been reported yet, so we represent this rare case to broaden the horizons regarding pancreatitis.
A 16-year-old woman suffered a painful lump in the upper abdomen. She came from a low-income family and frequently consumed cassava. There was intolerance of glucose in which admission blood sugar level of the patient increased by 179 mg/dl. An abdominal CT scan showed a mass around the pancreas, 20 cm in diameter, and located in retro-gastric. There were multiple ductal calculi along the major pancreatic duct with the largest stone was 3 cm in the pancreatic head. Longitudinal pancreaticojejunostomy (Partington-Rochelle procedure) has been performed and histopathological results appropriate with a pancreatic pseudocyst.
TCP with a giant pseudocyst is an interesting case report that has not been reported yet. This case met the clinical characteristics of TCP, such as young women, malnourished, history of cassava consumption, abdominal pain, and intolerance of glucose. A surgical intervention provides a satisfactory result to the patient.
Tropical chronic pancreatitis is a rare case. A pseudocyst adds the uniqueness of this case that has never been reported before. Appropriate management can provide satisfactory results and improve the quality of life for patients.
背景/目的：热带慢性胰腺炎（TCP）在发展中国家较为常见，被定义为慢性钙化性非酒精性胰腺炎的一种青少年形式。假性囊肿在20%至40%的慢性胰腺炎患者中出现。目前尚未有关于合并假性囊肿的TCP的报道，因此我们呈现这一罕见病例以拓宽胰腺炎相关视野。
一名16岁女性上腹部出现疼痛性肿块。她来自低收入家庭，经常食用木薯。存在葡萄糖不耐受情况，患者入院时血糖水平升高了179mg/dl。腹部CT扫描显示胰腺周围有一个直径20cm的肿块，位于胃后。沿主胰管有多个导管结石，最大的结石位于胰头，直径3cm。已进行纵向胰空肠吻合术（帕廷顿 - 罗谢尔手术），组织病理学结果符合胰腺假性囊肿。
合并巨大假性囊肿的TCP是一篇尚未见报道的有趣病例报告。该病例符合TCP的临床特征，如年轻女性、营养不良、有食用木薯史、腹痛和葡萄糖不耐受。手术干预为患者带来了满意的结果。
热带慢性胰腺炎是一种罕见病例。假性囊肿增加了该病例的独特性，此前从未有过报道。恰当的治疗可提供满意的结果并改善患者生活质量。
