上腹部痛を伴い，経過中に増大した胃迷入膵の1例

Symptomatic Aberrant Pancreas in the Stomach which Showed Gradual Growth, Report of a Case

要旨　患者は29歳，男性．2007年4月より上腹部痛が出現し，近医での上部消化管内視鏡検査にて異常所見を指摘され，当院を受診した．胃前庭部大彎に丈の低い粘膜下腫瘍を認め，超音波内視鏡検査で胃壁外に少量の腹水を認めた．確定診断に至らず，経過観察していたところ，約7か月後，上腹部痛が再度出現し，各種画像検査で腫瘍の増大を認めたため外科手術を施行した．病理組織所見は炎症性変化，嚢胞形成を伴った胃迷入膵と診断し，胃迷入膵に膵炎が発症し増大したものと考えた．術後，症状は消失し，現在まで再発は認めていない．

　A 29-year-old man was referred to our hospital because of abnormal endoscopic findings. Endoscopic examination revealed a protruded submucosal lesion in the gastric antrum, and EUS（endoscopic ultrasonography）examination showed a hypoechoic tumor in the 3rd to 4th layers, but there were few signs of malignancy. 8 months later the patient complained of epigastric pain again and EUS revealed a expansive increase in the size of the tumor and a new cystic component in the tumor. Aspiration cytodiagnosis showed class III cells. A subtotal gastrectomy was performed and histology of the resected specimen revealed normal pancreatic tissue, cysts and inflammatory fibrosis. The postsurgical clinical course was favorable and no relapse has been observed over the following 2 years.