The Evaluation of Pancreatogram: 2 Cases of Pancreatitis with Hyperparathyroidism.

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  • すい管像を検討し得た副甲状腺機能こう進症を合併したすい炎の2例

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Abstract

We investigated endoscopic retrograde cholangiopancreatography (ERCP) findings for 2 cases of pancreatitis with hyper-parathyroidism (HPT). Case 1: A 44-year-old man admitted to the hospital because of nausea, vomiting and upper abdominal pain in Septem-ber 16, 1994. He was diagnosed as acute pancreatitis and discharged after treatments. However he sometime had complained the same symptoms. He readmitted to the hospital because of severe abdominal pain. Laboratory data on admission showed elevated serum levels of pancreatic enzymes and calcium (Ca). Cervical ultrasonography was performed and parathyroid adenoma was detected. He was diagnosed as pancreatitis with HPT and parathyroidectomy was performed. After the operation, he has had no symptom and laboratory data have been within normal range. Case 2 : A 75-year-old man visited our hospital because of vomiting and upper abdominal pain in July 5, 1995. Elevated serum amylase and serum Ca level were found. Cervical ultrasonography revealed parathyroid adenoma. He was diagnosed acute pancreatitis with HPT and parathyroidectomy was performed. After parathyroidectomy, he has complained no symptoms and laboratory data have returned to normal range. We performed ERCP for both cases. In ERCP findings of case 1, pancreatic duct was almost normal, and case 2 revealed mild irregularity in main pancreatic duct and slightly dilated branches. Both cases showed the almost normal pancreatgrams and it was suggested that acute relapsing pancreatitis was developed by hypercalcemia due to HPT.

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