논문 상세보기
pp.163-167
특발성 재발성 췌장염은 원인 질환을 찾기 위한 다양한 접근이 필요한데 이 중 바터 팽대부내 종양의 경우에는 영 상학적 검사 외에도 내시경적 유두절개술을 통한 조직검사 와 같은 적극적인 원인 질환의 규명이 필요하겠다. 저자들 은 황달과 같은 담관 폐색에 의한 증상 없이 반복적인 췌장 염만 나타난 환자에서 바터 팽대부내선암을 경험하였기에 이를 보고한다.
Advances in imaging modalities have provided useful information in diagnosing ampullary lesions such as adenoma and adenocarcinoma. Endoscopic retrograde cholangiopancreaticography (ERCP) have a role in the diagnosis of unexposed intra-ampullarylesion. We report an interesting case of adenocarinoma of the ampulla of Vater presenting as idiopathic recurrent pancreatitis. A 56 years old woman was referred due to idiopathic recurrent pancreatitis for 2 years. She presented abdominal pain and upper abdominal tenderness. Magnetic resonance cholangiopancreaticography (MRCP) revealed minimal bile and pancreatic ductal dilatation without obstruction. Subsequent ERCP revealed a small polypoid lesion which was exposed after endoscopic sphincterotomy. Endoscopic biopsy showed papillary adenoma with low grade dysplasia. Additional endoscopic papillectomy was performed. Endoscopic biopsy done 3 months later showed papillary adenoma with high grade dysplasia. Pylorus preserving pancreatoduodenectomy was done and final pathology was well differentiated adenocarcinoma. The patient was recovered well but received adjuvant chemotherapy due to metastatic lymph nodes.
