The Korean Journal of Medicine

  • 제87권5호
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  • Pages.579-584
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  • 2014
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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췌관내유두상점액종양과 바터 팽대부 선종에 의한 급성 재발성 췌장염

A Case of Acute Recurrent Pancreatitis Caused by Branch Duct Type IPMN and Ampulla of Vater Adenoma with High Grade Dysplasia

  • 오창교 (한양대학교 의과대학 내과학교실) ;
  • 유기덕 (한양대학교 의과대학 내과학교실) ;
  • 최호순 (한양대학교 의과대학 내과학교실) ;
  • 이강녕 (한양대학교 의과대학 내과학교실) ;
  • 구건우 (한양대학교 의과대학 내과학교실) ;
  • 이승 (한양대학교 의과대학 병리학교실) ;
  • 장기석 (한양대학교 의과대학 병리학교실)
  • Oh, Chang Kyo (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Yoo, Ki Deok (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Choi, Ho Soon (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Lee, Kang Nyeong (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Koo, Gun Woo (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Lee, Seung (Department of Pathology, Hanyang University College of Medicine) ;
  • Jang, Ki Seok (Department of Pathology, Hanyang University College of Medicine)
  • 투고 : 2014.04.22
  • 심사 : 2014.06.23
  • 발행 : 2014.11.01
⟨ 이전 논문 다음 논문 ⟩

초록

특발성 급성 재발성 췌장염의 원인을 찾는 것은 환자의 치료방침 결정에 있어서 매우 중요하다. 1차적인 검사로 원인을 찾지 못한 췌장염의 경우 내시경 초음파, 내시경 역행성 담췌관 조영술 등의 내시경 검사로 적극적인 원인 규명이 필요하다. 저자 등은 최근 2개월 동안 두 차례의 급성 재발성 췌장염에 대해 기존의 영상학적인 검사 방법으로는 췌관내유두상점액종양 이외에는 특이 소견을 찾지 못하다가 내시경 역행성 담췌관 조영술로 바터 팽대부의 선종의 동반을 진단하고 내시경 유두괄약근 절개술 시행 후 호전된 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Acute pancreatitis is an inflammatory disease that can extend to extra-pancreatic tissues and distant organs. Detecting the underlying cause is important because it helps provide an appropriate treatment plan and improve prognosis. An underlying cause cannot be identified after initial evaluation in 10-30% of patients with acute pancreatitis, and they are diagnosed with idiopathic acute pancreatitis. Here, we report a case of a 77-year-old woman with acute recurrent pancreatitis caused by a branch duct-type intraductal papillary mucinous neoplasm (IPMN) and an ampulla of Vater adenoma. Abdominal computed tomography and magnetic resonance cholangiopancreatography revealed only IPMN. However, endoscopic retrograde cholangiopancreatography revealed a mucosal abnormality of the ampulla of Vater. The mucosal abnormality was documented to be an ampulla of Vater adenoma with high-grade dysplasia.

키워드

참고문헌

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