Pancreatic Pseudocyst Involving the Spleen

胰臟偽囊腫是急性胰臟炎常見的合併症，但是胰偽囊腫合併脾病變卻是臨床上罕見。一位有五年喝酒習慣的四十歲男性，由於左上腹部的陣發性疼痛，被轉送至本院接受治療。除了左上腹部壓痛外，理學檢查基本上是正常的。核磁共振攝影顯示分別在胰臟尾部及脾門處有兩個囊腫樣的病灶。同時，在脾左下方及骨脾韌帶處也有血管增生的現象。因為持續性的左上腹疼痛，病人接受開腹手術。術中，分別於胰藏尾部及脾門處發現囊腫的病灶。押取囊腫中的內含物，作澱粉酶的檢查，沔度高達20000IU/L。在確定胰偽囊腫合併脾病變診斷後，進行脾切除及胰遠端切除。病理檢查確定胰偽囊腫及脾栓塞。術後，病人恢復良好。謹就此病例報告之。

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並列摘要

The pseudocyst of the pancreas is a frequent complication of acute pancreatitis. The splenic involvement from the pancreatic pseudocyst is an uncommon entity. A 40year-old man, who had a five-year history of alcohol consumption, was referred to our hospital for treatment of throbbing pain over left upper quadrant (LUQ) of the abdomen. Except for LUQ tenderness, physical examination was essentially normal. MRI showed two cystic lesions in splenic hilum and pancreatic tail, and preminent vessels in left infrasplenic area and gastrosplenic ligament. Angiography revealed splenic vein thrombosis. Because of persistent LQU pain, he underwent laparotomy. During the operation, we found the cysts in pancreatic tail and splenic hilum. The cystic content was aspirated to check amylase, which showed the level of amylase being as high as 20000IU/L. The diagnosis of a pancreatic pseudocyst involving the spleen was established. Splenectomy and distal pancreatectomy were performed to remove both cysts. The pathologic examination of the resected spleen showed splenic infarction with cyst formation and pancreatic pseudocyst. The patient recovered uneventfully after operation.

並列關鍵字

pancreas ； psedocyst ； spleen

國際替代計量

Pancreatic Pseudocyst Involving the Spleen

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