不典型壶腹周围癌合并胆总管下段结石一例

Atypical periampullary carcinoma complicated with stones in the lower segment of common bile duct: a case report

壶腹周围癌是起源于Vater壶腹2 cm以内的恶性肿瘤,近年来,其发病率在国内外均呈上升趋势。由于其解剖位置复杂,周围邻近多组织和血管,早期症状缺乏特异性,故诊断困难。该文报道1例壶腹周围癌65岁女性患者,由于该患者基础疾病多,同时合并胆总管下段结石,临床表现不典型、影像学检查未见占位性病变,诊断困难。该文对壶腹周围癌诊断困难原因及经验教训进行分析,以期提高临床医师对壶腹周围癌的认识,为其早期诊断及治疗方案选择提供参考。

Periampullary carcinoma is a malignant tumor originating within 2 cm from Vater’s ampulla. In recent years, its incidence rate has been on the rise worldwide. It is difficult to diagnose because of complex anatomical position, surrounded by multiple tissues and blood vessels and nonspecific symptoms in early stage. In this article, a 65-year-old female patient with periampullary carcinoma was reported. She suffered from multiple primary diseases complicated with stones in the lower segment of common bile duct, atypical clinical manifestations, and no space-occupying lesions found by imaging examination, which increased the difficulty of diagnosis. The causes of the difficulties in the diagnosis of periampullary carcinoma and the experiences and failure patterns were analyzed,aiming to deepen the understanding of periampullary carcinoma and provide references for early diagnosis and treatment options.