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A Case of Gastric Accessory Pancreas Associated with Gastric Ulcer Simulating Early Cancer H. Murakami 1 , T. Iwazaki 1 1Dept. of Internal Medicine, Shizuoka City Hospital pp.931-934
Published Date 1974/7/25
DOI https://doi.org/10.11477/mf.1403111965
  • Abstract
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 A 61-year-old man was admitted to hospital complaining of epigastric fullness from which he suffered since several years before. On admission he was emaciated with tenderness in the epigastrium. Laboratory examination showed anemia and the feces was positive for occult blood. Double contrast method in x-ray revealed a niche, irregularity and marginal rigidity at the angle of the lesser cuvature. There was a well-defined flat elevation on the oral side at the posterior wall adjacent to the niche. Endoscopic examination also showed an open and irregular ulcer with mucosal convergence running from the anterior wall at the level of the angle. The converging mucosal folds did not exhibit any clubbiness or fusion at the tips. There was seen reddish swelling around the ulcer as well as a flat elevation with pale coarse granules at the posterior wall adjacent to the ulcer.

 The operation done under a provisional diagnosis of early stomach cancer macroscopically revealed an irregular ulcer, 20 × 10 mm, at the angle of the lesser curvature, accompanied with a slightly thick mucosal convergence. The flat elevation on the posterior wall adjacent to the ulcer looked normal in both consistency and color.

 An aberrant pancreatic tissue was histologically seen located under the flat elevation and a part of the ulcer, extending to the serosa through the submucosal layer. It simulated a normal pancreatic tissue. Orifices of some pancreatic ducts were open above the surface of the ulcer. It is interesting that pancreatic juice supposedly induced the ulcer by its digestive process.


Copyright © 1974, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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