摘要 :
Pancreatic pseudocyst is a widely recognised local complication following acute pancreatitis. Typically occurring more than four weeks after acute pancreatitis, a pseudocyst is a mature, encapsulated collection found within the pe...
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Pancreatic pseudocyst is a widely recognised local complication following acute pancreatitis. Typically occurring more than four weeks after acute pancreatitis, a pseudocyst is a mature, encapsulated collection found within the peripancreatic tissues manifesting as abdominal pain, structural compression, gastroparesis, sepsis and organ dysfunction. Therapeutic interventions include endoscopic transpapillary or transmural drainage, percutaneous catheter drainage and open surgery. We present our management of idiopathic chronic pancreatitis complicated by a pancreatic pseudocyst extending to the splenic capsule in a 38-year-old man. A trial of conservative management was sought, but later escalated to percutaneous fluoroscopic drainage. Despite a period of volume reduction of the pseudocyst, reaccumulation occurred. We describe successful surgical treatment via means of a splenocystojejunostomy and subsequent pain reduction.
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摘要 :
Mediastinal pancreatic pseudocysts are rare but lifethreatening complications of pancreatitis. Rupture and fistulization occur in approximately three percent of cases. The management of mediastinal pseudocysts remains controversia...
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Mediastinal pancreatic pseudocysts are rare but lifethreatening complications of pancreatitis. Rupture and fistulization occur in approximately three percent of cases. The management of mediastinal pseudocysts remains controversial and depends upon the exact location, etiology, ductal anatomy and expertise available. However, endoscopic interventions are increasingly used as the first modality of treatment. Here, we describe a case of mediastinal extension of a pancreatic pseudocyst successfully managed with endoscopic transpapillary drainage.
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摘要 :
Mediastinal pancreatic pseudocysts are rare but life-threatening complications of pancreatitis. Rupture and fistuli-zation occur in approximately three percent of cases. The management of mediastinal pseudocysts remains controvers...
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Mediastinal pancreatic pseudocysts are rare but life-threatening complications of pancreatitis. Rupture and fistuli-zation occur in approximately three percent of cases. The management of mediastinal pseudocysts remains controversial and depends upon the exact location, etiology, ductal anatomy and expertise available. However, endoscopic interventions are increasingly used as the first modality of treatment. Here, we describe a case of mediastinal extension of a pancreatic pseudocyst successfully managed with endoscopic transpapillary drainage.
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We commend Heinzow et al. for an interesting original article about the evaluation of technical results and clinical outcome rates of the single-step versus multi-step endoscopic ultrasonography (EUS) -guided endoscopic transmural...
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We commend Heinzow et al. for an interesting original article about the evaluation of technical results and clinical outcome rates of the single-step versus multi-step endoscopic ultrasonography (EUS) -guided endoscopic transmural drainage in patients with symptomatic pancreatic pseudocysts (PPC) of >4 cm size [1]. In a retrospective design of the study, they compared the results of 16 patients with PPC who had undergone single-step EUS-guided transmural drainage with a cohort of 22 patients who had undergone multi-step EUS-guided transmural drainage of PPC. Primary clinical success rate was 88% for single-step drainage and 90% for the multi-step approach (n.s.). The mean procedure time was 36 ± 9 min in the single-step group compared with 62 ± 12 min for the multi-step access (p < 0.001). They concluded that the use of single-step cystostomy appears useful in managing selected patients with symptomatic PPC as it is effective and time-saving.
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We report a 74-year-old Japanese woman with a spontaneously vanishing pseudocyst in the remnant pancreas intraductal papillary-mucinous a adenoma of the pancreas. A cystic lesion appeared in the remnant pancreas 6 months after the...
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We report a 74-year-old Japanese woman with a spontaneously vanishing pseudocyst in the remnant pancreas intraductal papillary-mucinous a adenoma of the pancreas. A cystic lesion appeared in the remnant pancreas 6 months after the operation and had disappeared 3 months later. When a cystic lesion is encountered in the remnant pancreas after pancreatectomy for mucinhypersecreting tumor of the pancreas, pseudocyst, as well as recurrence, should be considered in the differential diagnosis. Additional resection would likely cause considerable morbidity, with loss of endocrine and exocrine functions.
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This study examined the pathogenesis of large pseudocysts adjacent to knee joints in rheumatoid arthritis (RA). The radiological and histopathological features of 17 large subarticular pseudocysts in 12 knee joints of 10 patients ...
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This study examined the pathogenesis of large pseudocysts adjacent to knee joints in rheumatoid arthritis (RA). The radiological and histopathological features of 17 large subarticular pseudocysts in 12 knee joints of 10 patients were analyzed. Nine of the 10 patients were classified as class 2 according to Steinbrocker's functional class. Eight large pseudocysts were located at the lateral femoral condyle, seven were at the proximal part of the tibia, one was at the medial femoral condyle, and one was at the patella. The large pseudocysts were divided into two groups according to whether they did or did not connect with the joint cavity. Serial radiographs revealed that all large pseudocysts in communication with the joint cavity had enlarged gradually over the past several months. They extended from the subarticular area toward the bone marrow. Histopathological findings confirmed that holes allowing communication were located at a transitional zone between the ligament and the hyaline cartilage, andthat rheumatoid granulation tissue invaded the large pseudocyst through these holes. The results of this study indicate that large pseudocysts are formed by the extension of articular inflammation. Moreover, repeated extrinsic mechanical stress due to walking and the aggressive inflammatory nature of rheumatoid arthritis play important roles in the formation of large pseudocysts.
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A 22-month-old boy presents with intermittent fever and abdominal pain and tenderness. The patient has a history of premature birth at 28 weeks' gestational age complicated by intracranial hemorrhage with subsequent development of...
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A 22-month-old boy presents with intermittent fever and abdominal pain and tenderness. The patient has a history of premature birth at 28 weeks' gestational age complicated by intracranial hemorrhage with subsequent development of hydrocephalus necessitating ventriculoperitoneal (VP) shunt placement.
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The formation of pancreatic pseudocysts and (pseudo-)aneurysms of intestinal vessels are rare but life-threatening complications in acute and chronic pancreatitis. Here we report the rare case of a patient suffering from chronic p...
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The formation of pancreatic pseudocysts and (pseudo-)aneurysms of intestinal vessels are rare but life-threatening complications in acute and chronic pancreatitis. Here we report the rare case of a patient suffering from chronic pancreatitis with an arterial pseudoaneurysm within a pancreatic pseudocyst and present its successful therapeutic management by angioembolization to prevent critical bleeding. A 67-year-old male with a history of chronic pancreatitis presented with severe acute abdominal pain and vomiting to the emergency department. Seven weeks prior to the present admission, a CT scan had displayed a pancreatic pseudocyst with a maximum diameter of 53 mm. A laboratory examination revealed an elevated white blood cell count (15.40 × 103/μL), as well as elevated serum lipase (191 U/L), bilirubin (1.48 mg/dL), and blood glucose (353 mg/dL) levels. Sonographically, the previously described pancreatic pseudocyst revealed a slightly increased maximum diameter of 65 mm and an inhomogeneous echo of the cystic content. A contrast-enhanced CT scan showed a further increase in maximum diameter to 70 mm of the known pseudocyst. Inside the pseudocyst, a pseudoaneurysm originating from the splenic artery with a maximum diameter of 41 mm was visualized. After interdisciplinary consultation, prophylactic coil embolization of the splenic artery was immediately performed. The pseudoaneurysm was shut off from blood supply by back-door/front-door occlusion employing 27 coils, resulting in complete exclusion of the pseudoaneurysm from the circulation. Pseudoaneurysms are a rare complication of acute and chronic pancreatitis which has been shown to be efficiently treated by coil embolization.
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