重症急性膵炎を契機に診断した主膵管内進展を伴う十二指腸乳頭部癌の1例

抄録

A 95-year-old female was transported by ambulance to our hospital with abdominal pain and hospitalized by diagnosis of severe acute pancreatitis. Two years prior, she had developed severe acute pancreatitis that had improved with conservative treatment. However, the cause of pancreatitis had not been investigated because she was too elderly. This time abdominal contrast-enhanced computed tomography revealed a mass lesion with contrast effect in the main pancreatic duct and endoscopic retrograde cholangiopancreatography was performed. The papilla was enlarged and hemorrhagic. The diagnosis was well-differentiated adenocarcinoma of duodenal papilla by biopsied specimen. Pancreatography revealed mild enlargement of the pancreatic head and the filling defect in the main pancreatic duct. Therefore, invasion of duodenal papilla cancer into the main pancreatic duct could be the cause of the repeated severe acute pancreatitis. A 5Fr 7 cm straight pancreatic duct stent was placed and then, there has been no pancreatitis recurrence since.