Kazumori H, Ashizawa N, Moriyama N, Arima N, Hirakawa K, Adachi K, Watanabe M, Kinoshita Y, Tamura K
Department of Internal Medicine II, Shimane Medical University, Japan.
Int J Pancreatol. 1998 Oct;24(2):123-7. doi: 10.1007/BF02788570.
The clinical course of our patient suggests the association between chronic pancreatitis and primary sclerosing cholangitis (PSC), as well as the usefulness of prednisolone for the treatment of this condition.
Although alterations in the pancreatic duct have been reported, the association between chronic pancreatitis and PSC remains uncertain.
A long-term follow-up case of chronic pancreatitis accompanied by PSC is presented. A 58-yr-old man complaining of epigastric distress was admitted to our hospital in July 1990. Endoscopic retrograde cholangio-pancreatography (ERCP) showed a stricture of the distal common bile duct and a narrowing of the main pancreatic duct (MPD) with mild ectasia of its branches in the head of the pancreas. ERCP taken in June 1992 revealed localized narrowings in both the right and the left main hepatic ducts, and irregularity of the MPD through the entire pancreas. An ERCP taken in June 1996 showed a progression of the narrowings of the bile ducts. The patient was diagnosed as having chronic pancreatitis accompanied by PSC. ERCP revealed a remarkable improvement of the bile ducts after 4 wk of treatment with prednisolone.
我们患者的临床病程提示慢性胰腺炎与原发性硬化性胆管炎（PSC）之间存在关联，以及泼尼松龙对治疗这种病症的有效性。
尽管已有关于胰管改变的报道，但慢性胰腺炎与PSC之间的关联仍不明确。
本文报告了一例伴有PSC的慢性胰腺炎长期随访病例。一名58岁主诉上腹部不适的男性于1990年7月入住我院。内镜逆行胰胆管造影（ERCP）显示胆总管远端狭窄，主胰管（MPD）变窄，其胰腺头部分支轻度扩张。1992年6月的ERCP显示左右肝总管均有局限性狭窄，且整个胰腺的MPD不规则。1996年6月的ERCP显示胆管狭窄进展。该患者被诊断为伴有PSC的慢性胰腺炎。ERCP显示泼尼松龙治疗4周后胆管有显著改善。
