右鼠径部の疼痛と腫脹で発症した慢性膵炎急性増悪の1例

A case of acute aggravation of chronic pancreatitis with painful right inguinal swelling

骨盤部腹膜外腔は後腹膜と連続を有し，いくつかの経路から骨盤外へと連絡され，時として病変の思いがけない進展をきたす。鼠径管は骨盤腹膜外腔の骨盤腔外への開口部の一つで，骨盤腹膜外腔病変は鼠径管を経由して陰嚢や会陰部へ進展し得る。今回，我々は膵鉤部背側から右腎周囲腔，骨盤腹膜外腔を経て鼠径管内へ進展し，鼠径部の疼痛と腫脹で発症した慢性膵炎急性増悪の1例を経験したので報告する。

We report a case of acute aggravation of chronic pancreatitis with fluid collection tracked retroperitoneally into the inguinoscrotal region, traversing the deep and superficial inguinal ring. CT at the level of the pancreatic head showed right retromesenteric plane continuing to the right wall of the descending duodenum. Drainage of the fluid collection into the right retromesenteric plane might be insufficient due to this medial form of the plane. It was assumed that the insufficient fluid drainage into the retromesenteric plane caused fluid extension into the perirenal space and combined interfascial plane.