十二指腸粘膜下腫瘍を思わせた膵石症の1例

A Case of Pancreas Stone Presenting Roentgenologic Problems of Differentiation from Submucosal Duodenal Tumor

　膵石症は本邦では比較的少ないとされていたが，1971年第2回膵臓病研究会¹⁾で各大学から計121例の報告があり，また最近の診断技術の向上に伴い症例が増加しつっある．筆者らは最近，急性腹症で救急入院した患者で，腹部単純X線上，興味ある像を認め，低緊張十二指腸造影であたかもこの結石が十二指腸粘膜下腫瘍を思わせた1症例を経験したので報告する．

　This is a clinical report of a 53-year-old man who presented roentgenologic problems in the diagnosis of a calicified duodenal growth. A plain film showed two calcifications, one round and another oblong, with crystalline structural patterns in the area compatible with the bile duct and pancreas. The round calcified lesion, located in the upper region of the second portion of the duodenum, was protruding, heaving up the normal mucosa from underneath and looking like a submucosal tumor. When observed with a duodenofiberscope, it was a stone partially exposed from a 2 mm long opening. As the other stone was diagnosed as a pancreatic stone, the one in question was first thought of as a concretion of an accessory pancreas in the upper second portion of the duodenum, The final diagnosis made by endoscopic pancreatography disclosed that a round stone had developed at the orifice of the Santorini's duct and grew up into a size 2.5 cm in diameter, large enough to protrude into the duodenal lumen.