A CASE OF DUODENAL STENOSIS DUE TO ACUTE PANCREATITIS AFTER CONTINUOUS INTRA-ARTERIAL ADMINISTRATION

A 49-year-old man was admitted to the hospital because of severe epigastric pain. White blood cell count and serum CRP were high, the serum amylase, tripsin, phospholipase A2 and lipase were remarkably high on admission. The diagnosis of severe acute pancreatitis was made by CT scan of the abdomen. We performed continuous intra-arterial administration of FOY for 11 days, and pancreatitis improved. But he had nausea and vomiting, and the diagnosis of duodenal necrosis and stenosis was made by gastrofiberscope. The stenosis did not improve after 20 days, so PPPD was performed. Although leakage of duodenum-jejunum anastomosis was complicated, it was conservatively treated and he was discharged from the hospital 68 days after the operation. A duodenal stenosis due to pancreatitis is very rare. In a review of the Japanese literature, only 47 cases of duodenal stenosis due to pancreatitis including our case have been reported so far. We present a case of duodenal stenosis due to pancreatitis, together with some bibliographical comments.