临床误诊误治2018，Vol.31Issue(5)：16-22,7.DOI:10.3969/j.issn.1002-3429.2018.05.005
局灶性自身免疫性胰腺炎三例误诊误治分析
Analysis of Misdiagnosis and Mistreatment of Focal Autoimmune Pancreatitis in Three Patients
张古成 1陈桂豪2
作者信息
- 1. 510405广州,广州中医药大学第二临床医学院
- 2. 510120广州,广东省中医院大德路总院外一科
- 折叠
摘要
Abstract
Objective To conclude key points in diagnosis and differential diagnosis of focal autoimmune pan-creatitis(f-AIP),and to discuss its causes and preventive measures. Methods The retrospective analysis was con-ducted on the clinical data of three patients with f-AIP which was ever misdiagnosed. Results The three patients were hospitalized due to pain of upper abdomen with stained yellow of body and eyes. Abdominal CT,MR examination and other examinations revealed that two patients had focal enlargement of head of the pancreas and processus uncinatus, and the third patient had focal lesion of pancreas near ampullar region,and all the three patients had beak-like narrow-ness of lower segment of common bile duct with expansion of obstructive inner and outer cholangiectasis of the liver. They were misdiagnosed as pancreatic cancer or cancer of biliary duct before operation,wherein two patients underwent radical pancreatoduodenectomy,and diagnosed as having f-AIP by postoperative pathological examination;the third pa-tient was diagnosed as having f AIP after the treatment with diagnostic glucocorticoid. All the patients were discharged after recovery. Conclusion The f-AIP,as a kind of rare and special chronic pancreatitis in clinical settings,is un-likely to be identified from pancreatic cancer,cancer of biliary duct and other malignant tumor,and is generally misdi-agnosed. f-AIP should be taken into account if the patient has expression of obstructive jaundice in clinical settings,fo-cal mass of pancreas or focal lesion of ampullar region in imaging,as well as delayed enhancement in enhanced scan and beak-like narrow change of end of common bile duct,as revealed by imaging examination.关键词
胰腺炎/误诊/胰腺肿瘤/胆管肿瘤Key words
Pancreatitis/Misdiagnosis/Pancreatic neoplasms/Bile duct neoplasms分类
医药卫生引用本文复制引用
张古成,陈桂豪..局灶性自身免疫性胰腺炎三例误诊误治分析[J].临床误诊误治,2018,31(5):16-22,7.
