外科理论与实践 ›› 2025, Vol. 30 ›› Issue (03): 264-267.doi: 10.16139/j.1007-9610.2025.03.13
收稿日期:
2024-11-25
出版日期:
2025-05-25
发布日期:
2025-09-01
通讯作者:
杨玉龙,E-mail:yyl516@tongji.edu.cnReceived:
2024-11-25
Online:
2025-05-25
Published:
2025-09-01
摘要:
环状胰腺是一种相对罕见的先天性发育异常,影像学表现无特异性,所以有误诊的可能。本文报道1例术前误诊为壶腹部肿瘤的环状胰腺合并十二指肠球部狭窄致上消化道梗阻病例,经手术探查后确诊。通过回顾诊疗过程及文献复习,进一步探讨内镜下胰胆管造影术(ERCP)在该类疾病治疗中的潜在应用价值。
中图分类号:
于强, 杨玉龙. 环状胰腺合并十二指肠球部狭窄致上消化道梗阻(附1例报告)[J]. 外科理论与实践, 2025, 30(03): 264-267.
YU Qiang, YANG Yulong. Upper digestive tract obstruction caused by annular pancreas combined with duodenal bulb stenosis: a case report[J]. Journal of Surgery Concepts & Practice, 2025, 30(03): 264-267.
[1] | ZHENG H M, CAI X J, SHEN L G, et al. Surgical treatment of annular pancreas in adults: a report[J]. Chin Med J(Engl), 2007, 120(8):724-725. |
[2] |
ALI ALMOAMIN H H, KADHEM S H, SALEH A M. Annular pancreas in neonates; case series and review of literatures[J]. Afr J Paediatr Surg, 2022, 19(2):97-101.
doi: 10.4103/ajps.AJPS_180_20 pmid: 35017379 |
[3] | 汪学艳, 白琪, 冯泽东, 等. 环状胰腺诊治进展[J]. 中华肝脏外科手术学电子杂志, 2020, 9(3):216-220. |
WANG X Y, BAI Q, FENG Z D, et al. Progress in the diagnosis and treatment of annular pancreas[J]. Chin J Hepatic Surg, 2020, 9(3):216-220. | |
[4] |
EDMAN J, TURAIHI H, PATEL B, et al. Annular pancreas in adults: case report and literature review[J]. S D Med, 2019, 72(2):54-57.
pmid: 30855730 |
[5] | JOVANI M, LEE L S. Annular pancreas[J]. Clin Gastroenterol Hepatol, 2020, 18(7):A26. |
[6] | 王林燕, 薛佳金, 陈益, 等. 新生儿环状胰腺的临床诊治分析[J]. 浙江大学学报(医学版), 2019, 48(5):481-486. |
WANG L Y, XUE J J, CHEN Y, et al. Clinical diagnosis and treatment analysis of neonatal annular pancreas[J]. J Zhejiang Univ(Med Sci), 2019, 48(5):481-486. | |
[7] |
黎聪聪, 曾安祥. 胃癌误诊为环状胰腺并胰腺炎并十二指肠梗阻1例[J]. 广州医药, 2023, 54(8):76-82.
doi: 10.3969/j.issn.1000-8535.2023.08.013 |
LI C C, ZENG A X. Gastric cancer misdiagnosed as annular pancreas with pancreatitis and duodenal obstruction: a case report[J]. Guangzhou Med, 2023, 54(8):76-82. | |
[8] | XIANG H, HAN J, RIDLEY W E, et al. Crocodile jaw sign: annular pancreas[J]. J Med Imaging Radiat Oncol, 2018, 62(Suppl 1):69. |
[9] | CHEVALLIER P, SOUCI J, BUCKLEY M J, et al. Annular pancreas: MR imaging including MR cholangiopancreatography (MRCP)[J]. Pancreas, 1999, 18(2):216-218. |
[10] | ZYROMSKI N J, SANDOVAL J A, PITT H A, et al. Annular pancreas: dramatic differences between children and adults[J]. J Am Coll Surg, 2008, 206(5):1019-1025;discussion1025-1027. |
[11] | 巢佳灯, 喻强, 吴思远, 等. 门静脉型环状胰腺手术4例报道[J]. 手术电子杂志, 2022, 9(5):72-75. |
CHAO J D, YU Q, WU S Y, et al. Portal annular pancreas: a 4-case report[J]. Electron J Med Oper, 2022, 9(5):72-75. | |
[12] | 牛河源, 张俊晶, 乔建梁, 等. 胰腺导管腺癌伴环状胰腺解剖变异一例报道[J]. 中华普外科手术学杂志(电子版), 2021, 15(6):707-708. |
NIU H Y, ZHANG J J, QIAO J L, et al. A case of pancrea-tic ductal adenocarcinoma with annular pancreas anatomical variation[J]. Chin J Oper Proc Gen Surg(electronic edtion), 2021, 15(6):707-708. | |
[13] |
费晓斌, 王黔. 老年十二指肠降段不完全型环状胰腺一例及文献复习[J]. 腹部外科, 2021, 34(2):167-168,封3.
doi: 10.3969/j.issn.1003-5591.2021.02.019 |
FEI X B, WANG Q. A case of incomplete ring-shaped pancreas in the elderly duodenum and a literature review[J]. Abdom surg, 2021, 34(2):167-168,cover 3. | |
[14] | MOON S B. “Ductal adenocarcinoma in annular pancreas”: is it really an annular pancreas with pancreatic cancer?[J]. Int J Surg, 2015, 24(Pt A):7-8. |
[15] |
CANO D A, HEBROK M, ZENKER M. Pancreatic development and disease[J]. Gastroenterology, 2007, 132(2):745-762.
doi: 10.1053/j.gastro.2006.12.054 pmid: 17258745 |
[16] | MAKER V, GERZENSHTEIN J, LERNER T. Annular pancreas in the adult: two case reports and review of more than a century of literature[J]. Am Surg, 2003, 69(5):404-410. |
[17] | 陈可, 朱文成, 沈云娜, 等. 内镜下球囊扩张术治疗十二指肠瘢痕狭窄疗效分析[J]. 中国内镜杂志, 2007, 13(11):1222-1223. |
CEHN K, ZHU W C, SHEN Y N, et al. Endoscopic balloon dilatation for the treatment of duodenal scar stenosis: efficacy analysis[J]. China J Endosc, 2007, 13(11):1222-1223. | |
[18] | 朱楷, 刘煌, 曾勇, 等. 内镜下肠道金属支架置入治疗结直肠恶性梗阻的临床疗效[J]. 透析与人工器官, 2021, 32(4):3-4. |
ZHU K, LIU H, ZENG Y, et al. Clinical effect of endoscopic metal stent implantation in the treatment of patients with colorectal malignant obstruction[J]. Chin J Dial Artif Organs, 2021, 32(4):3-4. | |
[19] | 贺学强, 张泉, 莫春荣, 等. 临时支架辅助ERCP治疗球部狭窄急性重症胆管炎2例[J]. 现代消化及介入诊疗, 2023, 28(2):277-278,封3. |
HE X Q, ZHANG Q, MO C R, et al. Temporary stent-assisted ERCP treatment of acute severe cholangitis with duodenal stenosis in 2 cases[J]. Mod Intervent Diagn Treat Gastroenterol, 2023, 28(2):277-278,cover 3. | |
[20] |
GROMSKI M A, LEHMAN G A, ZYROMSKI N J, et al. Annular pancreas: endoscopic and pancreatographic findings from a tertiary referral ERCP center[J]. Gastrointest Endosc, 2019, 89(2):322-328.
doi: S0016-5107(18)33034-7 pmid: 30240880 |
[21] | 赖亚栋, 庄涵虚, 林淑惠, 等. 经内镜逆行胰胆管造影术在十二指肠良性狭窄合并胆总管结石中的应用价值[J]. 中华消化内镜杂志, 2020, 37(1):47-50. |
LAI Y D, ZHUANG H X, LIN S H, et al. The application value of endoscopic retrograde cholangiopancreatography in benign stenosis of the duodenum combined with choledochiasis[J]. Chin J Dig Endosc, 2020, 37(1):47-50. | |
[22] | 唐睿, 张海阳, 曹学冬, 等. 不同类型内镜逆行胰胆管造影术困难插管患者行胰管括约肌预切开术后的近期和远期疗效评价[J]. 中国内镜杂志, 2024, 30(5):48-55. |
TANG R, ZHANG H Y, CAO X D, et al. Evaluation of short-term and long-term effects of preincision of pancrea-tic duct sphincter in patients with different types of en-doscopic retrograde cholangiopancreatography difficult to intubate[J]. Chin J Endosc, 2024, 30(5):48-55. | |
[23] | BRÖNNIMANN E, POTTHAST S, VLAJNIC T, et al. Annular pancreas associated with duodenal carcinoma[J]. World J Gastroenterol, 2010, 16(25):3206-3210. |
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