Hemosuccus Pancreaticus: Diagnosed by Magnetic Resonance Images: A Case Report

Hemosuccus Pancreaticus：由磁振掃瞄攝影診斷：病例報告

陳旭漪(Hsu-Yi Chen) ； 曾旭明(Yuk-Ming Tsang) ； 王秀伯(Hsiu-Po Wang) ； 林肇堂(Jaw-Town Lin) ； 李伯皇(Po-Huang Lee) ； 魏達成(Dar-Cherng Wei) ； 吳振都(Chen-Tu Wu) ； 徐劍耀(Jane Chien-Yao Hsu)

《中華放射線醫學雜誌》 22卷4期 (1997/08) Pp. 171-175

摘要

本文提出一例因慢性胰臟炎併發脾動脈假性動脈瘤，並因其破裂到胰管而造成上消化道出血的報告。一位六十一歲男性病人因陣發性便血、吐血及左上腹痛而入院。電腦斷層掃瞄顯示在胰臟尾部有一個囊狀且中央有血管性顯影的病灶。磁振掃瞄攝影及磁振血管攝影皆確定此為一個血管性病變。病人接受手術治療，病理檢查顯示在脾動脈假性動脈瘤和胰臟假性囊腫之問有一廖管，此胰臟假性囊腫並與胰管相通。這是慢性胰臟炎一種相當罕見的併發症，其電腦斷層影像雖已被報告過，唯於英文文獻中對於電腦斷層掃瞄及磁振掃瞄攝影之影像表徵的關係卻未曾被探討。

關鍵字

腸胃道，出血 ； 胰臟，電腦斷層 ； 胰臟，磁振造影 ； 胰臟炎

並列摘要

This is a case report of gastrointestinal hemorrhage from a splenic artery pseudoaneurysm, secondary to chronic pancreatitis, through the pancreatic duct. A 61-year-old male presented with intermittent tarry stool and hematemesis which was associated with left epigastralgia. Computed tomography (CT) showed a central enhancing cystic lesion at the tail of the pancreas. Magnetic resonance (MR) images and MR angiogram confirmed the vascular nature of the lesion. The subsequent operation and pathological examination discovered a fistula between the pseudoaneurysm of the splenic artery and a pancreatic pseudocyst and the latter was communicated with the pancreatic duct. This is a rare complication of chronic pancreatitis. CT images of the disease have been presented, but MR images correlating with CT findings have only been reported a few times in the English literature.

並列關鍵字

Gastrointestinal tract, Hemorrhage ； Pancreas, CT ； Pancreas, MR ； Pancreatitis