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首页> 外文期刊>Journal of Surgical Case Reports >An incredibly dilated Wirsung mimicking a sero-cystic neoplasm of the pancreatic head
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An incredibly dilated Wirsung mimicking a sero-cystic neoplasm of the pancreatic head

机译：难以置信的Wirsung模仿了胰头的浆液性囊肿

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A diabetic patient who at a routine abdominal ultrasounds was found to have a very dilated pancreatic duct. Computed tomography (CT) scan diagnosed a sero-cystic lesion of the pancreatic head. Gastroduodenoscopy discovered a duodenal hyperemic area, which was sampled. Biopsy demonstrated intramucosal vascular emboli from a neuroendocrine carcinoma positive for Chromogranin A and Somatostatin and negative for Gastrin. Cholangio-magnetic resonance imaging revealed that the sero-cystic lesion found at CT, was being mimicked by the enormously dilated pancreatic duct but suggested the possibility of an intraductal or ampullar neoplasm. Blood and urine tests were not helpful and an octreoscan was negative. The patient underwent surgery. Direct exploration confirmed the severe pancreatic duct dilation and a cephalic lesion requiring a pancreatoduodenectomy. Histology confirmed a neuroendocrine tumor infiltrating the duodenum. We conclude that despite modern sophisticated imaging and endoscopic techniques, the evaluation of bilio-pancreatic region can be challenging and can reserve surgical surprises.
机译：例行常规腹部超声检查的糖尿病患者发现胰管非常扩张。计算机断层扫描（CT）扫描诊断为胰头有血清囊性病变。胃十二指肠镜检查发现了十二指肠充血区，并对其进行了采样。活检证实来自神经内分泌癌的黏膜内血管栓塞对嗜铬粒蛋白A和生长抑素呈阳性，对胃泌素呈阴性。胆管磁共振成像显示，CT处发现的浆液性囊性病变被巨大扩张的胰管模仿，但提示可能存在导管内或壶腹肿瘤。血液和尿液检查无济于事，奥氏扫描阴性。病人接受了手术。直接探查证实了严重的胰管扩张和需要进行胰十二指肠切除术的头颅病变。组织学证实神经内分泌肿瘤浸润十二指肠。我们得出的结论是，尽管采用了现代先进的成像技术和内窥镜技术，对胆小肠-胰腺区域的评估仍具有挑战性，并可能保留手术惊喜。

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