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A carcinoma in the dorsal part of the pancreas divisum with an annular pancreas in the anterior part is reported. A 79-yr-old female was admitted in our hospital complaining of epigastralgia. Computed tomography (CT) and ultrasound (US) showed an irregular mass in the pancreatic body. A pancreatogram obtained through the major duodenal papilla demonstrated only the ventral pancreatic duct that encircled the duodenum. Contrast medium injected from the minor duodenal papilla showed Santorini's duct obstruction at the neck portion of the pancreas without communication with the ventral pancreatic duct. The patient died with liver metastases. Autopsy confirmed annular pancreas and a 6-cm tumor in the pancreatic body extending to the pancreatic head and pancreas divisum. Pancreatic carcinoma; histologically a moderately differentiated adenocarcinoma; originated from the dorsal part of pancreas divisum. To our knowledge this is the first report of pancreatic carcinoma associated with annular pancreas coexistent with pancreas divisum.

肝シンチグラムで巨大な限局性欠損像を認め,肝良性腫瘍と診断し経過観察中,欠損像が自然縮小し確定診断の目的で開腹術を施行した結果,転移性肝癌であつた症例(20才の未婚女性)を報告した.本症例は胆管末端部,および,その周囲のリンパ節にも組織学的に悪性病変を認め,肝の悪性病変も膵癌の転移を示唆しており,初診後1年余を経た今日でも経過はきわめて良好である.肝シンチグラムで限局性欠損像の著明な自然縮小を認め,癌の自然退縮の可能性を示唆する希な症例である.なお本症例は経口避妊薬を使用しており,その服用中止後と欠損像の縮小とが時期的にほぼ一致していることから,癌との関連性もうかがわれ興味深い.

We studied the intest inal absorpt ion of the pat ients with the postoperat ive malabsorpt ion by means of 131I-labeled triolein, a lbumin and oleic acid, and 6~ labeled v i tamin B12. The rate of absorpt ion was expressed by the excret ion rate in 72 hours feces af ter the oral administration of 2 pc /kg lSlIlabeled substances, and in 24 hours urine af ter the oral adminis t ra t ion of 0.5/~c 6~ vi tamin B12. lalI-labeled tr iolein seemed to be the most reliable substance for the absorpt ion test. The normal excret ion rate remained less than 2%. After the operat ion of gas t rointes t inal tract , all of the pat ients with weight loss resul ted in impaired absorpt ion of triolein and oleic acid. The excret ion rate of tr iolein reached over 10% in the half of these patients. 75% of the pat ients with l iver diseases resul ted in impaired absorpt ion of fat. In the pa t ien ts with the shor tening of small bowel (after resect ion or blind loop formation), the average excret ion rate of fa t was 23.1% (2.9~67.0). The postgastrectomic malabsorpt ion had 15.3% in fecal recovery. After the par t ia l resection of large bowel, the impairment in the absorption of t r iolein was very s l ight (average fecal recovery was 4.1%). Any liver damage provoked the malabsorpt ion of fat and prote in in these patients . Circulus vi t iosus between the l iver damage and malabsorpt ion s ta tes was clinically and exper imental ly confined.