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腹痛,十二指肠溃疡,门静脉高压:非一般性“胰腺占位”

陆佳 郭涛 李骥 杨爱明 张太平 薛华丹 曹玮 冯瑞娥

陆佳, 郭涛, 李骥, 杨爱明, 张太平, 薛华丹, 曹玮, 冯瑞娥. 腹痛,十二指肠溃疡,门静脉高压:非一般性“胰腺占位”[J]. 协和医学杂志, 2020, 11(6): 766-773. doi: 10.3969/j.issn.1674-9081.2020.06.023
引用本文: 陆佳, 郭涛, 李骥, 杨爱明, 张太平, 薛华丹, 曹玮, 冯瑞娥. 腹痛,十二指肠溃疡,门静脉高压:非一般性“胰腺占位”[J]. 协和医学杂志, 2020, 11(6): 766-773. doi: 10.3969/j.issn.1674-9081.2020.06.023
LU Jia, GUO Tao, LI Ji, YANG Ai-ming, ZHANG Tai-ping, XUE Hua-dan, CAO Wei, FENG Rui-e. Abdominal Pain, Duodenal Ulcer, Portal Hypertension:Unusual 'Pancreatic Mass'[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(6): 766-773. doi: 10.3969/j.issn.1674-9081.2020.06.023
Citation: LU Jia, GUO Tao, LI Ji, YANG Ai-ming, ZHANG Tai-ping, XUE Hua-dan, CAO Wei, FENG Rui-e. Abdominal Pain, Duodenal Ulcer, Portal Hypertension:Unusual "Pancreatic Mass"[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(6): 766-773. doi: 10.3969/j.issn.1674-9081.2020.06.023

腹痛,十二指肠溃疡,门静脉高压:非一般性“胰腺占位”

doi: 10.3969/j.issn.1674-9081.2020.06.023
详细信息
    通讯作者:

    郭涛  电话:010-69151591, E-mail:guotao@pumch.cn

  • 中图分类号: R552

Abdominal Pain, Duodenal Ulcer, Portal Hypertension:Unusual "Pancreatic Mass"

More Information
    Corresponding author: GUO Tao  Tel: 86-10-69151591, E-mail:guotao@pumch.cn
  • 摘要: 一例青年男性患者,胰腺占位,侵犯十二指肠及门静脉,继发腹腔积液、消化道出血,病情复杂,诊疗难度大。经多学科团队共同讨论,考虑患者为胰腺结核,抗结核治疗过程中出现多种药物副反应,及时调整方案后获得了良好治疗效果。胰腺结核属于罕见病,对该例患者的诊治体现了多学科协作在疑难病诊疗过程中的重要意义。
    利益冲突  无
  • 图  1  腹部CT平扫+胰腺CT薄层扫描示胰头增大,密度不均匀(箭头,2019年4月9日)

    A.冠状面;B.横断面

    图  2  腹盆增强CT+胰腺CT薄层扫描图像(2019年4月29日)

    A.胰头增大,密度强化不均匀,较前加重(箭头);B.胰管轻度扩张(箭头);C.门静脉主干及肝内分支充盈不清(箭头),门静脉海绵样改变;D.食道胃底及门静脉其他属支多发静脉曲张(箭头)

    图  3  电子胃镜示中-重度食管静脉曲张呈现红色征(A,箭头),十二指肠球后黏膜凹陷,局部黏膜充血水肿明显(B,箭头)

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出版历程
  • 收稿日期:  2019-08-19
  • 录用日期:  2019-08-30
  • 网络出版日期:  2019-10-12
  • 刊出日期:  2020-11-30

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