同胞にみた膵石症の2例

Pancreatolithiasis in the Siblings, Report of 2 Cases

　慢性膵炎にたいする関心が急速にたかまっている現在，膵石症に関する報告例もしだいに増加しつつあるが，家族性にみられた膵石症となると，本邦では，まだわずか4家系の報告をみるにすぎない．このたび，われわれは兄弟にみられた膵石症例を経験したので，その概要について述べる．

　Familial pancreatic calculus has been reported so far in our country in only four family lines. In this paper are described two cases of pancreatic stones encountered in the male siblings.

　Case 1. A man 50 years old with chief complaints of pain in the epigastrium and back. When he was 47 years old, pancreatolith was pointed out by his doctor when he underwent x-ray examination of the stomach. He had been drinking about 1.8 liter of sake every day all through the past 15 years. Stones were confirmed by cholecystography, hypotonic duodenography and endoscopic pancreatocholedochography. Because of frequent bouts of pain we performed side-to-side anastomosis of the pancreas and jejunum. His convalescence was uneventful.

　Case 2. A man 42 years of age. At the age of 32 he noticed pain in the epigastrium and sense of heaviness in the back. A diagnosis of pancreatic stone was made at a certain hospital. Since then he bouts of pain about once a month. At 42 he was thoroughly examined at the National Cancer Center. He also had been drinking a bottle of beer a day over the past 20 years.

　Both cases showed lowered level of the three factors in the PS test, and scintillation camera was of little account in eliciting the shadow of the pancreas. He was also affected with diabetes mellitus.

　In both cases the problem remains unsettled whether pancreatolith was hereditary or not in the light of the patient's age and their drinking habit. It seems further necessary to examine parathyroid function and to determine the level of aminoacids in the urine as well as to make detailed investigation into the patient's ways of living and historis of their family.