Penetrierendes Ulcus duodeni als Primärmanifestation eines intraduktalen papillär-muzinösen Pankreastumors

Zusammenfassung

Ein 60-jähriger Patient mit chronischrezidivierenden Pankreatitiden und insulinpflichtigem Diabetes mellitus bot endoskopisch das Bild eines tief exkavierten Duodenalulkus, das unter 4-wöchiger parenteraler Ernährung sowie Protonenpumpenblocker-Therapie nicht abheilte. In der endoskopischen und bildgebenden Diagnostik ließ sich das Vorliegen eines primären Pankreasprozesses mit Anschluss an das Bulbusulkus nachweisen. Nach operativer Resektion durch eine pyloruserhaltende Duodenopankreatektomie konnte morphologisch ein abszedierender intraduktaler papillär-muzinöser Pankreastumor vom Borderline-Typ als Ursache des Duodenalulkus gesichert werden.

Penetrating duodenal ulcer as primary manifestation of an intraductal papillary-mucinous tumor of the pancreas

A 60-year-old patient with a history of chronic pancreatitis and insulin-dependent diabetes was admitted to our hospital with a deeply excavated duodenal ulcer showing no signs of regression under 4-week parenteral nutrition and proton pump inhibitor therapy. Radiologic and endoscopic diagnostics could demonstrate a primary tumor of the pancreatic head penetrating into the duodenal lumen. After surgical treatment by pylorus-preserving pancreatoduodenectomy an abscessing intraductal papillary-mucinous neoplasm of the pancreas was established morphologically.

Schlüsselwörter

Duodenalulkus - Pankreastumor - intraduktales papillär-muzinöses Neoplasma - chronische Pankreatitis

Key words

Duodenal Ulcer - Pancreatic Tumor - Intraductal Papillary-Mucinous Neoplasm - Chronic Pancreatitis

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