胃および脾臓へ穿破し, 脾膿瘍を合併した膵管内乳頭粘液性腺癌(IPMC)の1例 A case of pancreatic intraductal papillary-mucinous carcinoma with penetration to the stomach and splenic abscess

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著者

    • 立花 俊治 TACHIBANA Shunji
    • 京都府立医科大学消化器病態制御学 Molecular Gastroenterology and Hepatology, School of Medical Science, Kyoto Prefectural University of Medicine
    • 光藤 章二 MITSUFUJI Shoji
    • 京都府立医科大学消化器病態制御学 Molecular Gastroenterology and Hepatology, School of Medical Science, Kyoto Prefectural University of Medicine
    • 片岡 慶正 KATAOKA Keisho
    • 京都府立医科大学消化器病態制御学 Molecular Gastroenterology and Hepatology, School of Medical Science, Kyoto Prefectural University of Medicine
    • 岡上 武 OKANOUE Takeshi
    • 京都府立医科大学消化器病態制御学 Molecular Gastroenterology and Hepatology, School of Medical Science, Kyoto Prefectural University of Medicine

抄録

症例は80歳,男性.膵管内乳頭粘液性腺癌(IPMC)として経過観察中に胃穿破を生じ,次いで脾膿瘍を発症した.抗生剤の全身投与に加え,経皮的脾膿瘍ドレナージにより脾膿瘍は改善した.その後脾臓に新たな転移巣の出現と,胃への多発穿破を認め,初診より2年7カ月後に死亡した.膵癌と脾膿瘍の合併例の報告はまれであり,本症例における脾膿瘍形成は腫瘍の脾臓穿破に消化管からの逆行性感染を来したものと推察した.<br>

We report the case of an 80-year-old man given a diagnosis of pancreatic intraductal papillary-mucinous carcinoma (IPMC) and early gastric cancer. He refused surgery, therefore endoscopic mucosal resection (EMR) for gastric cancer and careful observation were performed. Penetration of the IPMC to the stomach was observed 3 months later. Ten months after the initial diagnosis, he was found to have a splenic abscess and was subsequently treated by antibiotics and percutaneous drainage, and a fistula between the IPMC and the splenic abscess was observed. We suppose IPMC penetration to the spleen and bacterial transmission from the stomach through the fistula caused the splenic abscess. While IPMC is recognized as a low-grade malignancy, some cases of invasive carcinoma with fistulation to adjacent organs have been reported. To the best of our knowledge, this is the first case of IPMC associated with splenic abscess due to pancreato-splenic fistula.<br>

収録刊行物

  • 日本消化器病學會雜誌 = The Japanese journal of gastro-enterology  

    日本消化器病學會雜誌 = The Japanese journal of gastro-enterology 103(7), 844-850, 2006-07-05 

    The Japanese Society of Gastroenterology

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各種コード

  • NII論文ID(NAID)
    10018364625
  • NII書誌ID(NCID)
    AN00192124
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    04466586
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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