腹部影像（一一一）胰臟炎併縱膈腔假性囊腫病例報告

10.6666/ClinMed.202202_89(2).0023

梁少嚴；張碧倚

胰臟炎（pancreatitis） ； 假性囊腫（pseudocyst） ； 縱膈腔假性囊腫（mediastinal pseudocyst）

臨床醫學月刊

89卷2期（2022 / 02 / 25）

124 - 127

繁體中文

一位45歲男性，有長期飲酒習慣與慢性胰臟炎（chronic pancreatitis）病史，此次因腹痛、腹脹前來就醫。電腦斷層與核磁共振顯示一個後腹腔囊腫，經由食道裂口（esophageal hiatus）延伸至縱膈腔。超音波導引經皮導管引流囊腫液體，檢驗出高濃度澱粉酶（amylase），故診斷為假性囊腫（pseudocyst）。其後配合持續引流、胰管支架置放、與抗生素治療，約兩個月後臨床症狀改善與假性囊腫縮小後即拔除引流管出院。

1. Bhasin, DK,Rana, SS,Rao, C(2012).Clinical presentation, radiological features, and endoscopic management of mediastinal pseudocysts: experience of a decade.Gastrointest Endosc,76,1056-1060.
2. Dąbkowski, K,Białek, A,Kukla, M(2017).Mediastinal Pancreatic Pseudocysts.Clin Endosc,50,76-80.
3. Karamouzos, V,Karavias, D,Siagris, D(2015).Pancreatic mediastinal pseudocyst presenting as a posterior mediastinal mass with recurrent pleural effusions: a case report and review of the literature.J Med Case Reports,9,110.
4. Kirchner, SG,Heller, RM,Smith, CW.(1977).Pancreatic Pseudocyst of the Mediastinum.Radiology,123,37-42.
5. Omer, A,Engelman, E,McClain, J(2018).Mediastinal extension of a pancreatic pseudocyst.Radiol Case Rep,13,1192-1194.
6. Rockacy, M,Khalid, A(2013).Update on pancreatic cyst fluid analysis.Ann Gastroenterol,26,122-127.
7. Sadat, U,Jah, A,Huguet, E(2007).Mediastinal extension of a complicated pancreatic pseudocyst; a case report and literature review.J Med Case Reports,1,12.
8. Segamalai, D,Abdul Jameel, AR,Kannan, N(2017).Mediastinal Pseudocyst: Varied Presentations and Management-Experience from a Tertiary Referral Care Centre in India.HPB Surg,2017,5247626.
9. Suga, H,Tsuruta, O,Okabe, Y(2005).A case of mediastinal pancreatic pseudocyst successfully treated with somatostatin analogue.Kurume Med J,52,161-164.
10. Tsujimoto, T,Takano, M,Tsuruzono, T(2004).Mediastinal pancreatic pseudocyst caused by obstruction of the pancreatic duct was eliminated by bromhexine hydrochloride.Intern Med,43,1034-1038.