中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2018, Vol. 40 ›› Issue (3): 328-333.doi: 10.3881/j.issn.1000-503X.2018.03.005

• 论著 • 上一篇    下一篇

十二指肠旁胰腺炎的临床特点和转归

李卓然1,曹迪1,李娟2,杨红1,韩显林3,薛华丹2,游燕4,周炜洵4,吴东1(),钱家鸣1   

  1. 1 中国医学科学院 北京协和医学院 北京协和医院 消化科,北京100730
    2 中国医学科学院 北京协和医学院 北京协和医院 放射科,北京100730
    3 中国医学科学院 北京协和医学院 北京协和医院 基本外科,北京100730
    4 中国医学科学院 北京协和医学院 北京协和医院 病理科,北京100730
  • 收稿日期:2018-04-10 出版日期:2018-06-30 发布日期:2018-07-05
  • 基金资助:
    卫生行业科研基金(201002020)

Clinical Features and Outcomes of Paraduodenal Pancreatitis

LI Zhuoran1,CAO Di1,LI Juan2,YANG Hong1,HAN Xianlin3,XUE Huadan2,YOU Yan4,ZHOU Weixun4,WU Dong1(),QIAN Jiaming1   

  1. 1 Department of Gastroenterology, PUMC Hospital,CAMS and PUMC,Beijing 100730,China
    2 Department of Radiology, PUMC Hospital,CAMS and PUMC,Beijing 100730,China
    3 Department of General Surgery, PUMC Hospital,CAMS and PUMC,Beijing 100730,China
    4 Department of Pathology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
  • Received:2018-04-10 Online:2018-06-30 Published:2018-07-05
  • Supported by:
    Supported by the Health Research & Special Projects Grant of China(201002020)

摘要:

目的 总结十二指肠旁胰腺炎(PP)的临床特点与转归。方法 回顾性分析北京协和医院5例和国内1988年以来报道的31例经临床或手术确诊的PP病例的临床资料,并做文献复习。结果 PP以中青年男性为主,多数有长期饮酒史,常见症状为上腹痛、呕吐、体质量减少和波动性黄疸,血清胰酶正常或升高。多数患者影像学表现存在十二指肠肠壁增厚及管腔狭窄(88.9%,32/36),约半数可见十二指肠壁及沟槽区域囊肿(47.2%,17/36),少数存在胆管(36.1%,13/36)或胰管扩张(16.7%,6/36)。病理表现主要为慢性胰腺炎,局部可伴急性炎症,炎症局限在胰沟-十二指肠。多数患者可通过保守治疗控制病情,少数需要手术。结论 PP好发于青壮年男性,影像学检查对于诊断十分重要,多数患者首选内科治疗。

关键词: 十二指肠旁胰腺炎, 沟槽状胰腺炎, 慢性胰腺炎, 十二指肠壁囊肿, 内镜逆行胰胆管造影

Abstract:

Objective To summarize the clinical features and outcomes of paraduodenal pancreatitis (PP).Methods Five clinically or pathologically diagnosed PP patients in Peking Union Medical College Hospital and 31 other PP cases reported in Chinese literature since 1988 were retrospectively analysed.Results Most PP patients were young or middle-aged males with a history of alcohol abuse. The clinical symptoms included upper abdominal pain,vomiting,weight loss,and fluctuating jaundice. Serum pancreatic enzymes were normal or elevated. Radiological features in most cases included thickening of the duodenal wall and duodenal stenosis (88.9%,32/36),cysts in the duodenal wall and groove area (47.2%,17/36),dilated bile duct (36.1%,13/36),and dilated pancreatic duct (16.7%,6/36). The main pathological finding was chronic pancreatitis,which could be accompanied by local acute inflammation,which was limited in the groove-duodenal area in most cases. The disease can be well controlled by conservative treatment,although surgery was needed in a small number of cases.Conclusions PP typically occurs in young or middle-aged males. Radiological examination is valuable for diagnosis. Conservative treatment is the mainstream treatment in most patients.

Key words: paraduodenal pancreatitis, groove pancreatitis, chronic pancreatitis, duodenal wall cyst, endoscopic retrograde cholangiopancreatography

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