Gardner's Syndrome with Recurrent Pancreatitis, Report of a Case Shunkichi Kai 1 1Department of Internal Medicine, Cancer Institute Hospital, Japanese Foundation for Cancer Research Keyword: 家族性大腸腺腫症 , 十二指腸乳頭部癌 , 膵炎 pp.642-646
Published Date 1997/3/25
DOI https://doi.org/10.11477/mf.1403105111
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 A 36-year-old man visited our institution with complaints of bloody stool and diarrhea. In July 1993, he was found to have numerous colonic adenomas, duodenal papilla adenoma and osteomas of mandibula, and was diagnosed with Gardner's syndrome (Fig. 2). In September 1993, the patient underwent a total colectomy with ileorectal anastomosis. The resected specimen showed as many as 5,157 polypoid lesions throughout the colon (Fig. 3). Follow-up examination revealed increase of the duodenal papilla in size for the 30 months, but malignant transformation was not detected at the time of endoscopic biopsy. Recurrent pancreatitis was thought to be caused by the obstruction of the pacreatic duct due to the enlarged duodenal papilla. Therefore the patient underwent endoscopic papillectomy in July 1996. Recurrent pancreatitis has disappeared since the procedure. The pathological diagnosis of the polypectomized specimen was a tubular adenoma with minute cancer which was limited within the mucosa (Fig. 6). Once invasive cancer of the duodenal papilla has developed, high mortality rate is expected. Therefore, it is important to repeat follow-up endoscopic examinations with biopsy for duodenal papilla adenoma. If it is resectable, endoscopic treatment may be recommended in its early stage.

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