主膵管の限局性狭窄

Localized Stricture of the Main Pancreatic Duct

患者　38歳，女性．

主訴　腹痛，発熱．

病歴　2001年8月上旬に健康診断で肝機能異常を指摘され精査を行い，US上，膵尾部に囊胞を認めた．ERCP検査で膵頭体部移行部の主膵管に不整な狭窄を認めたが，膵液細胞診はClass IIのため，経過観察されていた．急性膵炎を繰り返すため，手術目的で当科紹介となった．

既往歴　特記事項なし．

　A 38-year-old woman with episodes of acute pancreatitis was pointed out to have a stricture of the main pancreatic duct. Then, she was referred to us for surgical resection. Serum CEA was 0.9 ng／ml, and CA19―9 3.3 IU／ml. Computed tomography and magnetic resonance imagings showed no pancreatic abnormalities except a cystic mass in the hilum of the spleen. Endoscopic retrograde pancreatography showed stricture of the main pancreatic duct, 1 cm in size, in the body of the pancreas. The patient had segmental pancreatectomy and splenectomy. The histopathologic diagnosis was chronic pancreatitis as shown by fibrosis of the main pancreatic duct and the surrounding pancreatic parenchyma. She is doing well without signs of acute pancreatitis 32 months after the operation.

（Shokakigazo 2005 ; 7 : 857―860）