성인에서 발견된 췌장 가성낭종 양상을 보인 위 거대 중복낭종 1예

Abstract

Duplication of the alimentary tract is an unusual congenital anomaly which may occur at any level, from the oral cavity to the rectum. Gastric duplication cyst is quite rare and most of them are presented in infancy with the sypmtoms of vomiting, abdominal pain, weight loss, gastrointestinal bleeding resulting from partial or complete obstruction. Some cases have not been diagnosed until adult when duplication cyst is not large enough to cause acute obstruction in infancy. Our case is more unusual in the aspect of its presence in adult and its nature resembles huge pancreatic pseudocyst. A 18-year man came to our hospital with complaint of epigastric pain for three days. A gastrofiberoscopy revealed a round protruding mass with smooth surface of normal mucosa at the fundus and computed tomography of the abdomen revealed the presence of 6.0 X 6.0 cm sized cystic mass between posterior wall of stomach and pancreas, and another 2.0 x 2.0 cm sized mass in ant. wall of stomach, which were regarded as mutiple pancreatic pseudocysts in perigastric region. Endoscopic retrograde cholangiopancreatography did not disclose any pancreatic ductal abnormality or communication with the cyst. Endoscopic ultrasonography showed anechoic cystic mass under 3rd layer of stomach wall, which was removed by surgical resection. Postoperative pathologic examination disclosed multiple gastric duplications.