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.