Noda T, Ueno N, Tamada K, Ichiyama M, Fukuda M, Tomiyama T, Nishizono T, Tano S, Aizawa T, Iwao T
Department of Gastroenterology, Jichi Medical School, Tochigi, Japan.
Am J Gastroenterol. 1994 Nov;89(11):2066-9.
We report a case of chronic pancreatitis with pseudocysts complicated by infection and obstructive jaundice. A 49-yr-old male was admitted with the complaints of fever and jaundice. Laboratory findings included high biliary tract enzyme values and normal serum amylase value. Ultrasonography and computed tomographic scan demonstrated a cyst, 4 cm in diameter, in the pancreas head. Cholangiography revealed a long, tapered obstruction of the common bile duct which was apparently compressed by the cyst. Although the jaundice improved after percutaneous transhepatic biliary drainage, fever continued, and the cyst was aspirated. Bacteriological examination of the contents revealed infection. The symptoms disappeared rapidly and the cyst decreased in size soon after aspiration. The stenosis of the common bile duct showed improvement for several weeks but then regressed. In a patient with secondary pancreatic infection or obstructive jaundice following pancreatic disease, distinguishing the condition is an important aspect of accurate diagnosis and therapy.
我们报告一例慢性胰腺炎合并假性囊肿，并发感染和梗阻性黄疸。一名49岁男性因发热和黄疸入院。实验室检查结果显示胆道酶值升高而血清淀粉酶值正常。超声检查和计算机断层扫描显示胰头有一个直径4厘米的囊肿。胆管造影显示胆总管有一段长的、逐渐变细的梗阻，显然是被囊肿压迫所致。尽管经皮经肝胆道引流术后黄疸有所改善，但发热仍持续，遂对囊肿进行穿刺抽吸。对抽出物进行细菌学检查发现有感染。穿刺抽吸后症状迅速消失，囊肿大小很快缩小。胆总管狭窄在数周内有所改善，但随后又复发。对于胰腺疾病继发胰腺感染或梗阻性黄疸的患者，鉴别病情是准确诊断和治疗的重要方面。
