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英文誌(2004-)

Journal of Medical Ultrasonics

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1987 - Vol.14

Vol.14 No.03

Case Report(症例報告)

(0238 - 0243)

胃切除後の膵頭部腫瘤形成型慢性膵炎を腸間膜根部リンパ節腫大と誤診した1例

Tumor Forming Chronic Pancreatitis of the Head of the Pancreas, Misdiagnosed as an Enlarged Superior Mesenteric Lymphnode by Ultrasonography, Report of a Case

金 義哲, 西野 裕二, 山本 時忠, 藤本 泰久, 佐竹 克介, 梅山 馨

Eui-chol KIM, Hiroji NISHINO, Tokitada YAMAMOTO, Yasuhisa FUJIMOTO, Katsusuke SATAKE, Kaoru UMEYAMA

大阪市立大学医学部第一外科

The First Department of Surgery, Osaka City University Medical School

キーワード : Tumor forming chronic pancreatitis, Enlarged lymphnode, Kocher maneuver, Ultrasonography

Recently, we have experienced a tumor forming chronic pancreatitis of the head of the pancreas. The preoperative ultrasonography diagnosed an enlarged superior mesentric lymphnode due to metastasis from gastric cancer. The patient underwent a radical operation for gastric cancer by distal gastrectomy with Billroth I reconstruction 10 years ago. The Kocher maneuver for the mobilization of the duodenum was performed at the time of operation. This method caused the transposition of the head of the pancreas from the right to the left side of the aorta. This may be the cause of misdiagnosis in the ultrasonography. The result indicated that a transfer of the head of the pancreas by Kocher maneuver for Billroth I reconstruction should be taken into consideration in the ultrasonography.