A Case of Autoimmune Pancreatitis

A 38-year-old male was admitted to our hospital because of jaundice. 18 months before admission, he was diagnosed as insulin-dependent diabetes mellitus. Then we could detect no abnormalities of abdominal CT scan. On this admission abdominal US revealed hypoechoic swelling of pancreas. ERCP demonstrated focal narrowing of the main pancreatic duct and constriction of the common bile duct in the pancreas with dilatation of upstream. Pathological finding of pancreas was infiltration of inflammatory cells (lymphocytes, eosinophils and plasma cells) and fibrosis. Pathological findings of gall bladder and lymphnode were similar to that of pancreas. We diagnosed his illness as autoimmune pancreatitis. After surgery jaundice improved but swelling of pancreas continued. Though we recommended steroid therapy, he refused it. We are carefully following.