憩室様突出像を示した胃迷入膵の1例

A Case of Aberrant Pancreas in the Stomach with Pseudodiverticular Pouch

　胃粘膜下腫瘍には種々の病変が報告され，最近では術前に性状を診断する各種の方法が考案されている．われわれは，X線検査で胃前庭部大彎に憩室様突出像をみとめ，組織診で迷入膵によると考えられた症例を経験したので報告する．

　A 61-year-old male visited Akita University Hospital with complaints of postprandial epigastric dullness of 2 months duration.

　Roentgenographic findings of the stomach revealed a diverticular-like protrusion on the greater curvature in the antrum.

　Endoscopic findings revealed an excavation with protruded margin but adjacent gastric mucosa hardly altered. Biopsy specimen from this area showed atrophic gastritis. Laboratory examinations were within normal limit. Operation was performed under suspected diagnosis of aberrant pancreas.

　Histologically, pseudodiverticular pouch was an excavation with muscularis mucosa of gastric mucosa, which located in submucous layer, and intradiverticular mucosa consisted of normal gastric mucosa without intestinal metaplasia. Aberrant pancreatic tissue was found in the proximal site near pseudodiverticular pouch.