Clinical Endoscopy

  • 제42권4호
  • /
  • Pages.259-262
  • /
  • 2011
  • /
  • 2234-2400(pISSN)
  • /
  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지

캡슐내시경 시행 후 단일포트 복강경 수술로 제거한 공장의 이소성 췌장

Heterotopic Pancreas of the Jejunum Identified by Capsule Endoscopy

  • 공시은 (가톨릭대학교 의과대학 내과학교실) ;
  • 백창렬 (가톨릭대학교 의과대학 내과학교실) ;
  • 김은정 (가톨릭대학교 의과대학 내과학교실) ;
  • 김형진 (가톨릭대학교 의과대학 외과학교실) ;
  • 정지한 (가톨릭대학교 의과대학 병원병리학교실) ;
  • 정우철 (가톨릭대학교 의과대학 내과학교실) ;
  • 이강문 (가톨릭대학교 의과대학 내과학교실) ;
  • 양진모 (가톨릭대학교 의과대학 내과학교실)
  • Kong, Si-Eun (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Paik, Chang-Nyol (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Eun-Jung (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Hyung-Jin (Department of Surgery, The Catholic University of Korea College of Medicine) ;
  • Jung, Ji-Han (Department of Hospital Pathology, The Catholic University of Korea College of Medicine) ;
  • Chung, Woo-Chul (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Lee, Kang-Moon (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Yang, Jin-Mo (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
  • 발행 : 2011.04.30
⟨ 이전 논문 다음 논문 ⟩

초록

이소성 췌장은 정상 췌장과 해부학적 또는 혈관을 통한 연관성 없이 고유의 위치가 아닌 다른 부위에서 발견되는 비교적 드문 질환으로 전 위장관에서 발생할 수 있다. 위와 소장에서 가장 흔하게 발견되는데 상부위장관내시경 검사를 통해 위와 십이지장에서 많이 발견되며 내시경이 도달하지 않는 소장에서는 상부위장관 수술 후 우연히 발견된다. 대부분 무증상으로 드물게 복통, 체중감소, 출혈, 장폐쇄 등을 유발할 수 있다. 이번 증례는 간헐적으로 복통을 호소한 49세 남자환자에서 캡슐내시경이 공장 점막하 병변을 의심하는데 도움이 되었던 경우이다. 이후 정확한 진단과 치료를 위해 단일포트 복강경 공장 구역절제술 후 공장 이소성 췌장으로 확진한 증례로 환자는 수술 후 특이증상 없이 외래 추적관찰 중이다.

Heterotopic pancreas is an uncommon condition that commonly occurs in the gastrointestinal tract such as the stomach and small bowel. It is defined as the presence of pancreatic tissue outside its usual location and lacking anatomical and vascular continuity with the pancreas. A heterotopic pancreas is usually found incidentally and is mostly silent; however, it rarely causes abdominal pain, weight loss, bleeding, or ileus. A 49-year-old male presented with intermittent abdominal pain for 4 weeks. We report a case with submucosal features of a jejunal heterotopic pancreas with the aid of capsule endoscopy and a histological confirmation through a single port laparoscopic segmental jejunectomy.

키워드

참고문헌

  1. Christodoulidis G, Zacharoulis D, Barbanis S, Katsogridakis E, Hatzitheofilou K. Heterotopic pancreas in the stomach: a case report and literature review. World J Gastroenterol 2007;13:6098-6100. https://doi.org/10.3748/wjg.13.6098
  2. Eisenberger CF, Gocht A, Knoefel WT, et al. Heterotopic pancreas--clinical presentation and pathology with review of the literature. Hepatogastroenterology 2004;51:854-858.
  3. Hirasaki S, Kubo M, Inoue A, Miyake Y, Oshiro H. Jejunal small ectopic pancreas developing into jejunojejunal intussusception: a rare cause of ileus. World J Gastroenterol 2009;15:3954-3956. https://doi.org/10.3748/wjg.15.3954
  4. Tanaka K, Tsunoda T, Eto T, et al. Diagnosis and management of heterotopic pancreas. Int Surg 1993;78:32-35.
  5. Hirasaki S, Tanimizu M, Moriwaki T, Nasu J. Acute pancreatitis occurring in gastric aberrant pancreas treated with surgery and proved by histological examination. Intern Med 2005;44:1169-1173. https://doi.org/10.2169/internalmedicine.44.1169
  6. Chen HL, Lin SC, Chang WH, Yang TL, Chen YJ. Identification of ectopic pancreas in the ileum by capsule endoscopy. J Formos Med Assoc 2007;106:240-243. https://doi.org/10.1016/S0929-6646(09)60246-1
  7. Um JW, Joe YG, Kim IS, Bae JW. Ductal adenocarcinoma arising from the heterotopic pancreas situated in the jejunum. J Korean Surg Soc 2000;58:735-739.
  8. Joo YE, Kim HS, Choi SK, et al. Massive gastrointestinal bleeding caused by ectopic pancreas mimicking jejunal tumor. Digestion 2001;64:133-136. https://doi.org/10.1159/000048853
  9. Barbosa JJ, Dockerty MB, Waugh JM. Pancreatic heterotopia. Surg Gynecol Obstet 1946;82:527-542.
  10. Dolan RV, ReMine WH, Dockerty MB. The fate of heterotopic pancreatic tissue. A study of 212 cases. Arch Surg 1974;109:762-765. https://doi.org/10.1001/archsurg.1974.01360060032010
  11. Amstrong CP, King PM, Dixon JM, Macleod IB. The clinical significance of heterotopic pancreas in the gastrointestinal tract. Br J Surg 1981;68:384-387. https://doi.org/10.1002/bjs.1800680606
  12. Kok VK, Wang TK, Lin NH, Bei JJ, Huang PH, Chen YC. Adult intussusception caused by heterotopic pancreas. J Formos Med Assoc 2007;106:418-421. https://doi.org/10.1016/S0929-6646(09)60329-6
  13. Nam YS, Park HK, Baik HK, Lee HG, Jang SJ, Park YW. Partial intestinal obstruction by pancreatic adenomyoma of jejunum. J Korean Surg Soc 1997;53:450-455.
  14. Rana SS, Bhasin DK, Nada R, Gupta R, Singh K. Heterotopic pancreas in the jejunum presenting as a submucosal lesion on endoscopy. JOP 2009;10:419-420.
  15. Park BK, Park SJ, Paik YH, et al. Endoscopic findings of ectopic pancreas in the stomach. Korean J Gastrointest Endosc 1999;19:739-746.
  16. Tsurumaru D, Utsunomiya T, Kayashima K, et al. Heterotopic pancreas of the jejunum diagnosed by double-balloon enteroscopy. Gastrointest Endosc 2007;66:1026-1027. https://doi.org/10.1016/j.gie.2007.06.015
  17. Takeda Y, Nakase H, Chiba T. Ectopic pancreas at the jejunum. Dig Liver Dis 2011;43:e6. https://doi.org/10.1016/j.dld.2010.03.022
  18. Kim HJ, Lee JI, Lee SC, et al. Single-port laparoscopic appendectomy. J Korean Surg Soc 2010;78:338-342. https://doi.org/10.4174/jkss.2010.78.5.338