A case of intraductal papillary tumor in main pancreatic duct with acute pancreatitis as the first diagnostic clue *
An 62- year - old man visited on our hospital, because he had experienced several attacks of epigastric pain and back pain during the previous six months. The diagnosis on admission was acute pancreatitis, which was determined by elevation of pancreatic enzymes. Ultrasonographically, dilatation of the main pancreatic duct was detected, and a polypoid lesion was observed within it. The lesion was suspected to be an intraductal tumor, but this could not be detected by CT and MRCP. However, ERCP revealed a polypoid lesion without mucin in the main pancreatic duct. Therefore, partial pancreaticoduodenostomy of the intraductal papillary tumor was performed. The lesion was pathologically diagnosed as an intraductal papillary adenoma. Since then, the patient did not have any furthur attacks of pancreatitis. Intraductal papillary tumors that do not produce mucin, such as the one in this case, may not be detected by CT and MRCP. Therefore, a careful examination for this disease should be made in cases with acute pancreatitis. (Accepted on May 22, 2001) Kawasaki Igakkaishi 27(2)139-143, 2001
