Inoue Teruaki, Oikawa Ryo, Shimura Eri, Ito Tatsuhiro, Kaneko Naoya, Mori Masashi
Department of Internal Medicine, Fujinomiya City General Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2022;119(3):267-272. doi: 10.11405/nisshoshi.119.267.
A 62-year-old male patient was referred to our hospital for jaundice and bloody feces. He had hyper-IgG4-emia. Computed tomography (CT) showed diffuse pancreatic enlargement, pancreatic pseudocyst, and hematoma of the splenic flexure of the colon. Magnetic resonance imaging (MRI) showed a fistula in the pancreatic pseudocyst and splenic flexure of the colon. Moreover, lower gastrointestinal endoscopy showed a fistula in the same region. Endoscopic retrograde cholangiopancreatography (ERCP) showed narrowing of the main pancreatic duct and stenosis of the lower bile duct. Following this, the patient was diagnosed with autoimmune pancreatitis-induced pancreatic pseudocyst and colonic perforation-induced gastrointestinal bleeding. The pancreatic pseudocyst and fistula were resolved through steroid treatment.
一名62岁男性患者因黄疸和便血被转诊至我院。他存在高IgG4血症。计算机断层扫描（CT）显示胰腺弥漫性肿大、胰腺假性囊肿以及结肠脾曲血肿。磁共振成像（MRI）显示胰腺假性囊肿与结肠脾曲之间存在瘘管。此外，下消化道内镜检查显示同一区域存在瘘管。内镜逆行胰胆管造影（ERCP）显示主胰管狭窄以及低位胆管狭窄。此后，该患者被诊断为自身免疫性胰腺炎诱发的胰腺假性囊肿以及结肠穿孔诱发的胃肠道出血。通过类固醇治疗，胰腺假性囊肿和瘘管得以消退。
