Ball valve syndromeにより急性膵炎を発症した胃癌の1例

A case of gastric cancer with acute pancreatitis induced by ball valve syndrome

胃内の腫瘍や粘膜が十二指腸内に陥入し，腹痛，嘔吐，腹部膨満などをきたす病態はball valve syndromeと呼ばれる。今回我々はball valve syndromeにより急性膵炎をきたした症例を経験したので，画像所見を中心に文献的考察を交えて報告する。

Ball valve syndrome occurs when a gastric tumor or mucous membrane herniates into the duodenum and occludes the gastric outlet. In this report, we described a case of ball valve syndrome with acute pancreatitis.

A female patient presented with abdominal pain and nausea, then she was referred to our hospital and undertook CT scan. The CT showed herniation of gastric tumor into duodenum and gastroduodenal intussusception. In addition, the mass occluded major duodenal papilla and then led to the dilatation of common bile duct and pancreatic duct. We diagnosed ball valve syndrome from the imaging findings. Endoscopy confirmed that gastric cancer herniated into the duodenal diverticulum.

This syndrome is sometimes associated with cholangitis and pancreatitis. Consequently, we have to be careful of the occlusion of common bile duct and pancreatic duct in imaging diagnosis.