膵管像を検討し得た副甲状腺機能亢進症を合併した膵炎の2例  [in Japanese] THE EVALUATION OF PANCREATOGRAM ; 2 CASES OF PANCREATITIS WITH HYPERPARATHYROIDISM  [in Japanese]

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Abstract

副甲状腺機能亢進症(HPT)を合併した膵炎2例の膵管像を検討した.いずれも常習飲酒家で過去に急性膵炎の診断を受けて以来禁酒していたが,腹痛,嘔吐を繰り返し,受診時,膵酵素上昇,血清Ca値上昇,副甲状腺腫を認めた.腺腫摘出後,自覚症状,検査値の異常は認めていない.両者の膵管像は1例は正常で他の1例も軽度の主膵管の口径不同を認めるのみであった.以上より2例はHPTによる高Ca血症に伴う急性再発性膵炎と考えられた.

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.

Journal

  • GASTROENTEROLOGICAL ENDOSCOPY

    GASTROENTEROLOGICAL ENDOSCOPY 38(11), 2677-2681, 1996-11-20

    Japan Gastroenterological Endoscopy Society

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