抄録
We had experienced a case of diffuse disseminated pancreato-lithiasis which manifested with severe sugar metabolic insufficiency.
The patient was 53 years old male with a history of laparotomy for an epigastric tumor in 1955.
After five years, in 1969, he was admitted to Atami National Hospital with chief complaints of nausea, anorexia, diarrhea, malnutrition and thirst. In this first hospitalization sugar metabolic insufficiency was well controlled by P. Z. I. and R. I. Proteinuria, hematuria and hypertension were not discovered, but he had diabetic retinopathy. Thereafter, he had been received insuline therapy in the out patient clinic.
In 1964 he was admitted to the hospital again with pyothorax. At this time the sugar metabolic insufficiency was aggravated, and the increase of blood pressure, neuralgic pain, proteinuria and hematuria were observed.
In the middle of May, 1965, he had a hypoglycemic episode, and in June he had to be hospitalized for hypertension, edema and diarrhea. In this 3rd hospitalization the control of diabetes by insuline was very difficult. He was suffered from the disturbance of speech and consciousness. Finaly he died on the 19th of July of heart failure caused by bronchopneumonia.
At autopsy pancreatic tissue was almost completely destroyed by fibrinization, and the numerous grayish white, irregular shaped, crenate stones were cramed in pancreatic ducts. But calcification of pancreatic tissue was not observed. In kidney typical pathological changes of diabetic glomerulonephritis were seen. Arteriosclerosis was noticed in aorta, coronal and cerebral arteries. Numerous micro softnings were separated in cerebral tissues. In right lung severe bronchopneumonia was seen.
The patient died of pancreatic insufficency with diffuse and disseminated calcification. The significance of this case is its wide distribution of pancreatic calcifications with progressive insular deficiency, and without remarkable failure in secreting funetinon of pancreas.
