消化性潰瘍と膵炎をともなった急性原発性副甲状腺機能亢進症の1例

Abstract

A case of acute hyperparathyroidism associated with peptic ulcer and pancreatitis was reported. The patient was a 47-year-old man who had been treated as peptic ulcer since 1973. In June 1977, with various complaints of general fatigue, anorexia, nausea, vomiting, polydypsia and polyuria, he was treated by gastrectomy on July 5, 1977. On the 8th postoperatively, he again complained of epigastralgia, with general fatigue. At that time the laboratory examinations revealed significant rise of BUN and serum amylase levels as well as serum calcium. Then he was admitted to the Shirasagi Hospital for further evaluation. The final diagnosis was concluded as acute primary hyperparathyroidism associated with acute pancreatitis. Following appopriate infusion and use of calcitonin, the general condition improved markedly and BUN and amylase returned nearly to the normal level. Then the patient was hospitalized in our department for exploration of the neck on September 27, 1977. The operation revealed the enlarged lower parathyroid gland, 2×2×1 cm, on right side and normal other parathyroid glands. The pathological study as well as operative findings showed parathyroid adenoma. Postoperative course was not eventful without tetany and all symptoms disappeared. The literatures were reviewed briefly about acute hyperparathyroidism.