主膵管と交通を認めた巨房型膵囊胞腺腫の1例

Megacystic Type Cystadenoma of the Pancreas Communicating to the Main Pancreatic Duct, Report of a Case

要旨患者は79歳，女性．心窩部痛および腹部膨満感を主訴に来院し，腹部超音波検査にて膵尾部に多房性の巨大膵囊胞を認めた．来院時血清アミラーゼは正常であったが同年5月23日，重篤な急性膵炎および麻痺性イレウスを併発し緊急入院となった．内科療法にて軽快後，ERPを施行し主膵管との交通を有する14×16cm大の巨大膵囊胞腺腫を認めた．悪性との鑑別が困難なため，手術を行った．組織学的には粘液性膵囊胞腺腫であった．

　A 79-year-old female visited our hospital complaining of epigastralgia and abdominal fullness, but laboratory data at the OPD including serum amylase level were within normal limits. A few days later, she developed sudden onset of severe abdominal pain and was admitted to our hospital due to acute pancreatitis and paralytic ileus (Fig. 1). Abdominal sonogram and CT scan revealed a multi-loculated cyst in the tail of pancreas (Fig. 2). ERCP showed a large pancreatic cyst which lead to the main pancreatic duct (Fig. 3). Microscopic examination of the surgically resected specimen showed the mucinous type cystadenoma of the pancress.