담낭선암의 괴사조직에 의한 급성 췌장염 1예
A Case of Acute Pancreatitis Caused by the Necrotic Tissue of Gallbladder Cancer
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급성 췌장염의 가장 흔한 원인은 담석으로 알려져 있다. 그러나 원인이 알려지지 않은 특발성의 경우도 10∼15%를 차지하며, 이는 담즙찌꺼기가 총담관 폐쇄를 유발하여 췌장염을 일으키는 것으로 생각된다. 같은 기전으로 콜레스테롤 용종이나 콜레스테롤 침착증, 혈액담즙증에서도 담도성 동통이 유발될 수 있으며, 이때는 용종의 일부나 혈전이 담즙 찌꺼기처럼 급성췌장염을 발생하는 것으로 알려져 있다. 저자들은 52세 남자에서 담낭선암의 괴사조직으로 인해 유발된 급성췌장염을 진단하고, 복강경 담낭절제술과 간 분절절제술로 치료한 1예를 경험하여 문헌고찰과 함께 보고한다.
Abstract
The most common cause of acute pancreatitis is gallstones. However, idiopathic causes comprise about 10 to 15% of all cases of acute pancreatitis. Biliary sludge is thought to be a cause of idiopathic acute pancreatitis and mainly via obstruction of the common bile duct. Cholesterol polyps of the gallbladder, cholesterolosis and hemobilia can be associated with biliary pain. Fragments of the gallbladder polyps and blood clots can lead to acute pancreatitis in a way similar to that of biliary sludge. Yet it has never been reported that the necrotic tissue of gallbladder cancer can lead to acute pancreatitis. Herein, we report on the case of a 52-year-old man with acute pancreatitis that was caused by the necrotic tissue of gallbladder cancer. The necrotic tissue in the bile duct was revealed on endoscopic retrograde cholangiopancreatography (ERCP). The patient was successfully treated by laparoscopic cholecystectomy along with liver segmentectomy.
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