胃迷入膵の膵炎に関連したと思われる消化管出血の1例

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  • ACUTE GASTRIC HEMORRHAGE ASSOCIATED WITH PANCREATITIS OCCURRING IN GASTRIC ABERRANT PANCREAS TISSUE : REPORT OF A CASE

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A rare case of gastric hemorrhage associated with pancreatitis occurring in gastric aberrant pancreas tissue is reported. The patient was a 35-year-old man with a history of heavy intake of alcohol. He was referred to hospital because of vomiting, epigastric pain and tarry stool. Emergent endoscopic examination revealed a 4 cm hemispheric, sub-mucosal mass with ulceration of overlying mucosa and hemorrhage located on the greater curvature of the gastric antrum. The urine amylase was moderately elevated, although the serum amylase was normal range. Upper gastrointestinal radiography revealed a 4×3 cm submucosal, sessile mass on the greater curvature of the gastric antrum. Following endoscopic examination 1 month after the first endoscopy revealed a 1.5 cm cylindrical nipplelike submucosal projection. The tumor became smaller. The ulcer and hemorrhage were disappeared. Partial gastrectomy was performed for the prevention of the relapse due to heavy drinking of alcohol. The pathological findings showed aberrant pancreas tissue in the gastric muscular layer and heaped-up mucosa with a central depression.

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