A case of aberrant pancreas in the mesentery of the small intestine, detected incidentally during surgery for colorectal cancer
We report a case of multiple primary carcinomas of the rectum and sigmoid colon with aberrant pancreas in the mesentery of the small intestine. A 60-year-old man was admitted to our hospital due to colonic obstruction. Emergency computed tomography (CT) and colonoscopy showed evidence of tumors in t...
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| Published in | Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 73; no. 9; pp. 2383 - 2386 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japan Surgical Association
2012
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1345-2843 1882-5133 |
| DOI | 10.3919/jjsa.73.2383 |
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| Abstract | We report a case of multiple primary carcinomas of the rectum and sigmoid colon with aberrant pancreas in the mesentery of the small intestine. A 60-year-old man was admitted to our hospital due to colonic obstruction. Emergency computed tomography (CT) and colonoscopy showed evidence of tumors in the rectum and sigmoid colon. A colostomy was performed as a temporary measure. After the patient was discharged from the hospital to prepare for the curative operation, he was again hospitalized due to adhesive intestinal obstruction. A second operation showed an ileus due to a band at the jejunum (approximately 40 cm distal to the ligament of Treitz) and a firm nodule(25 mm) in the mesentery nearby. The nodule was highly suggestive of mesenteric dissemination of the carcinomas ; however, aberrant pancreas was confirmed in a specimen obtained intraoperatively. Detachment of the adhesive intestine and low anterior resection were performed. The nodule was subsequently diagnosed as aberrant pancreas (Heinrich type I). |
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| AbstractList | We report a case of multiple primary carcinomas of the rectum and sigmoid colon with aberrant pancreas in the mesentery of the small intestine. A 60-year-old man was admitted to our hospital due to colonic obstruction. Emergency computed tomography (CT) and colonoscopy showed evidence of tumors in the rectum and sigmoid colon. A colostomy was performed as a temporary measure. After the patient was discharged from the hospital to prepare for the curative operation, he was again hospitalized due to adhesive intestinal obstruction. A second operation showed an ileus due to a band at the jejunum (approximately 40 cm distal to the ligament of Treitz) and a firm nodule(25 mm) in the mesentery nearby. The nodule was highly suggestive of mesenteric dissemination of the carcinomas ; however, aberrant pancreas was confirmed in a specimen obtained intraoperatively. Detachment of the adhesive intestine and low anterior resection were performed. The nodule was subsequently diagnosed as aberrant pancreas (Heinrich type I). |
| Author | YAMADA, Masaki SATOU, Masahiko NEGAMI, Naoki SAITOU, Tetsuya ISHIDO, Yasunori WATABE, Suguru |
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| References | 4) 大井 実，三穂乙実，伊東 保他:非癌性異腫瘍―全国93主要医療施設からの集計的検査―．外科 1967;29:112-133 15) 金子明代，栗原竜一，蓮沼 理他:経過観察中に胃迷入膵が癌化したと考えられる1例．日消誌 2005;102:1423-1428 9) 佐藤雅彦，高橋 玄，渡部 英他:巨大嚢胞形成にて前庭部狭窄をきたした胃の異所性膵の1例．日臨外会誌 2009;70:1039-1043 2) Pearson S : Aberrant pancreas : Review of the literature and report of three cases, one of which produced common and pancreatic duct obstruction. Am Arch Surg 1951 ; 63 : 168-184 11) Persson GE, Boiesen PT : Cancer of aberrant pancreas in jejunum. Acta Chir Scand 1988 ; 154 : 599-601 14) 山下 豊，村田育夫，岩永整磨他:胃迷入膵より発生した腺癌の1例．Gastroenterol Endosc 1989;31:436-441 1) 富岡 勉，田島義証，鬼塚伸也他:異所性膵．別冊日本臨牀領域別症候群シリーズ，膵症候群，10，日本臨牀社，大阪，1996，p7-10 13) 三枝奈芳紀，田中寿一，土屋俊一他:異所性膵組織から発生したと考えられた小腸癌の1例．手術 1995;49:715-717 12) 佐藤哲也，田渕純宏，猪野睦征他:空腸に発生した異所性膵癌の1例．日臨外会誌 1993;54:703-706 10) 辻 和宏，池田宏国，三谷英信他:腸閉塞症で発症した成人回腸迷入膵の1例．日消外会誌 2003;36:1703-1707 8) 藤瀬直樹，高原 耕，遠近裕宜他:小腸間膜内異所性膵より発生したsolid and cystic tumorの1例．日臨外会誌 1993;54:181-185 16) 吉田素平，渡部祐司，堀内 淳他:胃前庭部から発生し十二指腸球部に嵌入を認めた嚢胞形成性迷入膵の1例．日消外会誌 2006;39:1511-1516 3) Barbosa JC, Dockerty MB, Waugh JM : Pancreatic hetrotopia. Review of the literature and report of 41 authenticated surgical cases, of which 25 were clinically significant. Surg Gynecol Obstet 1946 ; 82 : 527-542 5) Lauche A : Die Heterotopien des ortsgehörigen Epitheles im Bereich des Verdauungskanails. Virchows Arch Pathol Anat Physiol Kim Med 1924 ; 252 : 39-88 6) Heinrich H : Ein Beitrag zur Histologie des sogen. akzessorischen Pankreas. Virchows Arch Pathol Anat Physiol Klim Med 1909 ; 198 : 392-401 7) 金子 猛，礒部 潔，笠原正男:急性膵炎で発症した小腸間膜異所性膵組織の1例．日消外会誌 2003;36:46-50 11 12 13 14 15 16 1 2 3 4 5 6 7 8 9 10 |
| References_xml | – reference: 8) 藤瀬直樹，高原 耕，遠近裕宜他:小腸間膜内異所性膵より発生したsolid and cystic tumorの1例．日臨外会誌 1993;54:181-185 – reference: 15) 金子明代，栗原竜一，蓮沼 理他:経過観察中に胃迷入膵が癌化したと考えられる1例．日消誌 2005;102:1423-1428 – reference: 4) 大井 実，三穂乙実，伊東 保他:非癌性異腫瘍―全国93主要医療施設からの集計的検査―．外科 1967;29:112-133 – reference: 14) 山下 豊，村田育夫，岩永整磨他:胃迷入膵より発生した腺癌の1例．Gastroenterol Endosc 1989;31:436-441 – reference: 2) Pearson S : Aberrant pancreas : Review of the literature and report of three cases, one of which produced common and pancreatic duct obstruction. Am Arch Surg 1951 ; 63 : 168-184 – reference: 9) 佐藤雅彦，高橋 玄，渡部 英他:巨大嚢胞形成にて前庭部狭窄をきたした胃の異所性膵の1例．日臨外会誌 2009;70:1039-1043 – reference: 12) 佐藤哲也，田渕純宏，猪野睦征他:空腸に発生した異所性膵癌の1例．日臨外会誌 1993;54:703-706 – reference: 7) 金子 猛，礒部 潔，笠原正男:急性膵炎で発症した小腸間膜異所性膵組織の1例．日消外会誌 2003;36:46-50 – reference: 1) 富岡 勉，田島義証，鬼塚伸也他:異所性膵．別冊日本臨牀領域別症候群シリーズ，膵症候群，10，日本臨牀社，大阪，1996，p7-10 – reference: 11) Persson GE, Boiesen PT : Cancer of aberrant pancreas in jejunum. Acta Chir Scand 1988 ; 154 : 599-601 – reference: 5) Lauche A : Die Heterotopien des ortsgehörigen Epitheles im Bereich des Verdauungskanails. Virchows Arch Pathol Anat Physiol Kim Med 1924 ; 252 : 39-88 – reference: 10) 辻 和宏，池田宏国，三谷英信他:腸閉塞症で発症した成人回腸迷入膵の1例．日消外会誌 2003;36:1703-1707 – reference: 3) Barbosa JC, Dockerty MB, Waugh JM : Pancreatic hetrotopia. Review of the literature and report of 41 authenticated surgical cases, of which 25 were clinically significant. Surg Gynecol Obstet 1946 ; 82 : 527-542 – reference: 13) 三枝奈芳紀，田中寿一，土屋俊一他:異所性膵組織から発生したと考えられた小腸癌の1例．手術 1995;49:715-717 – reference: 16) 吉田素平，渡部祐司，堀内 淳他:胃前庭部から発生し十二指腸球部に嵌入を認めた嚢胞形成性迷入膵の1例．日消外会誌 2006;39:1511-1516 – reference: 6) Heinrich H : Ein Beitrag zur Histologie des sogen. akzessorischen Pankreas. Virchows Arch Pathol Anat Physiol Klim Med 1909 ; 198 : 392-401 – ident: 3 – ident: 6 doi: 10.1007/BF02085327 – ident: 4 – ident: 1 – ident: 12 – ident: 11 – ident: 2 doi: 10.1001/archsurg.1951.01250040172006 – ident: 5 doi: 10.1007/BF01960720 – ident: 10 – ident: 13 – ident: 16 – ident: 14 – ident: 15 – ident: 9 – ident: 7 – ident: 8 |
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| Title | A case of aberrant pancreas in the mesentery of the small intestine, detected incidentally during surgery for colorectal cancer |
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