Yasui A, Nimura Y, Kondou S, Kamiya J
First Department of Surgery, Nagoya University School of Medicine, Japan.
Hepatogastroenterology. 1995 Nov-Dec;42(6):1017-22.
A patient with obstructive jaundice due to carcinoma of the pancreas head showed painless vomiting from the supra-papillary duodenal obstruction. Computed tomography demonstrated a space-occupying lesion in the head of the pancreas, which was not so large as to make an obstruction of the proximal portion of the duodenum. Pylorus preserving pancreatoduodenectomy was performed and the surgical specimen showed that the duodenal obstruction was caused by a swollen annular pancreas associated with obstructive pancreatitis by the carcinoma of the pancreas head. Duodenal obstruction is a rare symptom of annular pancreas in adults. It is thought to be necessary to remind of the coexistence of the annular pancreas, when patients with pancreatic or periampullary malignancies are complicated with unexpected obstruction of the second portion of the duodenum in proportion to the size.
一名因胰头癌导致梗阻性黄疸的患者出现了由乳头上方十二指肠梗阻引起的无痛性呕吐。计算机断层扫描显示胰头有占位性病变，但其大小尚不足以导致十二指肠近端梗阻。遂行保留幽门的胰十二指肠切除术，手术标本显示十二指肠梗阻是由与胰头癌相关的梗阻性胰腺炎导致的环状胰腺肿大所致。十二指肠梗阻是成人环状胰腺的罕见症状。当胰腺或壶腹周围恶性肿瘤患者出现与肿瘤大小不成比例的十二指肠第二部意外梗阻时，认为有必要提醒环状胰腺的共存情况。
