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Pseudocyst of pancreas

Michail Papamichail, Amir Ali, Michail Pizanias, Praveen Peddu, John Karani, Nigel Heaton
BACKGROUNDS/AIMS: Resection or enucleation is currently the treatment of choice for small pancreatic neuroendocrine tumors (NETs). Irreversible electroporation is a novel ablative method that is used for locally advanced pancreatic adenocarcinoma, but little data exists for its use for pancreatic NETs. We report an early experience of IRE for early pancreatic NETs. METHODS: Between April 2014 and March 2015, 3 patients with small (<2 cm) pancreatic NETs were treated with percutaneous IRE...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Zeeshan Ahmed, Sanjeev Chhabra, Ashish Massey, Vikesh Vij, Rahul Yadav, Rajendra Bugalia, Jeevan Kankaria, Raj K Jenaw
INTRODUCTION: Hydatid disease is caused by the larval stage of Echinococcus granulosus. It most commonly affects the liver and lung. Pancreatic hydatid cyst (PHC) is very rare with incidence of 0.14%-2%. PRESENTATION OF CASE: A 40year old lady presented with epigastric pain for last 3 months. A 5×5cm abdominal lump occupying the epigastric and left hypochondrial region was noted on physical examination. Ultrasonography (USG) and Contrast enhanced Computed Tomogrpahy (CT) revealed a 55×57mm cystic structure in the pancreatic body...
2016: International Journal of Surgery Case Reports
Toni Raffoul, Alexandre Balaphas, Raphael P H Meier, Catrina Hansen, Giacomo Puppa, Jean-Louis Frossard, Philippe Morel, Leo H Bühler
The detection rate of cystic lesions of the pancreas has increased following the widespread use of high-resolution imaging technologies. CT-scan, MRI and echo-endoscopy are diagnostic modalities. Pseudocyst is the most common lesion. It is benign and can be managed with endoscopic treatment. Mucinous cystic neoplasia and Intraductal Papillary Mucinous Neoplasia (IPMN) carry a risk for malignant transformation. The surgical treatment of these lesions has to be discussed by a multidisciplinary board. Serous cystic neoplasia and pseudopapillar and solid neoplasia are two rare types of lesion...
June 15, 2016: Revue Médicale Suisse
Ahmed Mahmoud Hamza, Emad Helmi Ayyash, Raed Alzafiri, Issam Francis, Sami Asfar
Gastrointestinal stromal tumours (GISTs) are solid tumours of the gastrointestinal tract, mostly found in the stomach and intestine. They rarely present as cystic lesions. A 74-year-old woman referred to the hepatopancreaticobiliary unit, with 3 months history of upper abdominal discomfort. Abdominal ultrasound scan showed a large cystic lesion in the epigastric region suggestive of a pancreatic pseudocyst. The CT-scan showed a 6.6×6×6.3 cm size cyst related to the pancreas and extending to the hepatogastric omentum...
2016: BMJ Case Reports
Kohei Sato, Kazuteru Monden, Toru Ueki, Masashi Tatsukawa, Hiroshi Sadamori, Kousaku Sakaguchi, Norihisa Takakura
A man in his 60s with epigastric pain was diagnosed with acute pancreatitis and subsequently recovered following conservative treatment. However, because of repeated upper abdominal pain and the formation of a pancreatic pseudocyst, he was transferred to our institution for evaluation. Dynamic computed tomography (CT) scanning confirmed abnormal vessels in the tail of the pancreas and early venous return to the splenic vein in the early arterial phase. Abdominal angiography revealed a racemose vascular network in the tail of the pancreas, confirming the presence of an arteriovenous malformation (AVM) in this region...
July 2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Surinder Singh Rana, Ravi Sharma, Puneet Chhabra, Vishal Sharma, Rajesh Gupta, Deepak Kumar Bhasin
BACKGROUND: Splenic pseudocysts (SP) are a rare consequence of both acute and chronic pancreatitis. Surgery has been conventional treatment for SP and literature on role of endoscopic treatment is scant. In this study, we retrospectively evaluated SP clinical and radiological characteristics as well as the outcome following endoscopic drainage. METHODS: Retrospective analysis of SP patients seen at our unit from January 2002 to June 2015. All patients were treated with attempted endoscopic transpapillary drainage with a nasopancreatic drain or stent...
July 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
H M M T B Herath, Aruna Kulatunga
BACKGROUND: Acute pancreatitis is an acute inflammatory process of the pancreas that can trigger a systemic inflammatory response. Pulmonary embolism refers to obstruction of the pulmonary artery or one of its branches by material (usually a thrombus) that originated elsewhere in the body. Extensive lower limb deep vein thrombosis with pulmonary embolism is a rare complication of acute pancreatitis that has been described in a few case reports. Deep vein thrombosis and hypercoagulable states in pancreatitis are thought to be due to release of pancreatic proteolytic enzymes from a cyst that is connected to the pancreatic duct and penetrates into a vessel...
2016: Journal of Medical Case Reports
Thilo Hackert, Markus Wolfgang Büchler
The management of acute necrotizing pancreatitis (ANP) has undergone a change of paradigms during the last 2 decades with a decreasing impact of surgical interventions. Modern ANP management is done conservatively as long as possible and therapeutic approaches aim at volume resuscitation, pain management and early enteral nutrition. The diagnostic gold standard of contrast-enhanced CT scan helps to evaluate the extent of necrosis of the pancreas, which correlates with the risk of tissue infection. The crucial point for decision making is the proven existence of infected pancreatic necrosis...
2016: Digestive Diseases
Mircea Beuran, Ionut Negoi, Fausto Catena, Massimo Sartelli, Sorin Hostiuc, Sorin Paun
BACKGROUND: Pancreatic pseudocysts are the most common complication of acute and chronic pancreatitis. They account for 75% of the cystic lesions of the pancreas. CASE REPORT: A 37 year-old woman was admitted three months after an episode of severe acute pancreatitis with a large tumor mass located in her left abdomen, abdominal tenderness and asthenia. Abdominal Computed Tomography (CT) revealed a giant pancreatic pseudocyst of 23/15/12 centimeters. We performed an anterior laparoscopic transgastric cystogastrostomy...
June 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
Sala Abdalla, Ioannis Nikolopoulos, Rajab Kerwat
Extra-abdominal complications of pancreatitis such as pancreaticopleural fistulae are rare. A pancreaticopleural fistula occurs when inflammation of the pancreas and pancreatic ductal disruption lead to leakage of secretions through a fistulous tract into the thorax. The underlying aetiology in the majority of cases is alcohol-induced chronic pancreatitis. The diagnosis is often delayed given that the majority of patients present with pulmonary symptoms and frequently have large, persistent pleural effusions...
2016: Case Reports in Emergency Medicine
L B Xiang, Y X Tu, T C He, X Pei, X X Shen, W T Yang, X H Wu, H J Yang
OBJECTIVE: The aim of this study is to evaluate the safety and efficacy of partial pancreatectomy as part of primary cytoreductive surgery in advanced epithelial ovarian cancer (EOC). METHODS: A total of 8 patients were recruited in this study who underwent partial pancreatectomy during the primary cytoreductive surgeries for advanced EOC in Fudan University Shanghai Cancer Center from April 2009 to July 2015. Their clinicopathological characteristics, diameter of metastatic tumors, the scope of cytoreductive surgeries, residual diseases after cytoreductive surgeries, postoperative complications and survival situation were retrospective analyzed...
May 25, 2016: Zhonghua Fu Chan Ke za Zhi
Nima Hafezi-Nejad, Vikesh K Singh, Stephen I Johnson, Martin A Makary, Kenzo Hirose, Elliot K Fishman, Atif Zaheer
Chronic pancreatitis (CP) is an irreversible, inflammatory process characterized by progressive fibrosis of the pancreas that can result in abdominal pain, exocrine insufficiency, and diabetes. Inadequate pain relief using medical and/or endoscopic therapies is an indication for surgery. The surgical management of CP is centered around three main operations including pancreaticoduodenectomy (PD), duodenum-preserving pancreatic head resection (DPPHR) and drainage procedures, and total pancreatectomy with islet autotransplantation (TPIAT)...
October 2016: Abdominal Radiology
Anand Singla, Darshanjeet Singh Walia, Rishabhpreet Kaur
Gastric outlet obstruction in adults is usually caused by pyloric stenosis secondary to peptic ulcer disease or malignancy. However, there are few other causes such as a foreign body and external compression due to pseudocyst pancreas. We present a rare aetiology of a large collection of pus in the lesser sac in our patient causing gastric outlet obstruction. A perforated peptic ulcer was suspected in our patient who had symptoms of sudden onset pain in epigastric region which was referred to back. This was followed by pain in upper abdomen, vomiting, constipation and fever for which patient was being managed conservatively before being referred to us...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
Lawen Karim, David Larkin, Mohamed Sadat
We present the case of a 70-year-old man with a giant right-sided retroperitoneal pseudocyst, confirmed histologically after resection to be benign with appearances dissimilar to pancreatic and adrenal tissue. The cyst was noted incidentally on table at the time of laparoscopic surgery. Retroperitoneal pseudocysts most commonly arise from the pancreas and adrenal glands occurring as a result of an inflammatory process. Primary retroperitoneal pseudocysts are a rare entity. This case highlights the importance of examining the patient thoroughly and not focusing on the obvious...
2016: Journal of Surgical Case Reports
John M Ruggero, Shivana N Prakash
Lymphoepithelial cysts (LECs) of the pancreas are rare benign lesions with unknown pathogenesis. LECs are true cysts that mimic pseudocysts and cystic neoplasms making diagnosis challenging. We report a case of a symptomatic LEC of the pancreas in a 67-year-old man who had severe epigastric pain. Workup including computed tomography and endoscopic ultrasound were non-diagnostic. The patient underwent attempted surgical resection; however, the mass was unresectable. The mass was enucleated and drained, and pathology returned LEC...
2016: Journal of Surgical Case Reports
Sheshang U Kamath, Satish B Dharap
Management of isolated traumatic pancreatic duct disruption remains challenging due to associated morbidity and mortality. Two children with isolated pancreatic ductal disruption were treated conservatively. Both developed a pseudocyst which resolved spontaneously due to the atrophy of the distal pancreas in a five-year-old girl while remained persistent and was treated by endoscopic cystogastrostomy in an eight-year-old boy. Non-operative management may be pursued in patients with pancreatic ductal injury in the hope of a pseudocyst formation which may spontaneously resolve or may be treated later with a minimally invasive procedure...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
Hiren G Patel, Yana Cavanagh, Sohail N Shaikh
CONTEXT: Chronic pancreatitis is an inflammatory condition that may result in progressive parenchymal damage and fibrosis which can ultimately lead to destruction of pancreatic tissue. Fistulas to the pleura, peritoneum, pericardium, and peripancreatic organs may form as a complications of pancreatitis. This case report describes an exceedingly rare complication, pancreaticoureteral fistula (PUF). Only two additional cases of PUF have been reported. However, they evolved following traumatic injury to the ureter or pancreatic duct...
March 2016: North American Journal of Medical Sciences
L Havlůj, B Mlýnek, R Gürlich
UNLABELLED: The pseudocyst of the pancreas is one of the most common cystic lesions of the pancreas. The pseudocysts can be defined as intrapancreatic, peripancreatic or extrapancreatic fluid collections with a defined wall formed mostly on the basis of acute or chronic pancreatitis. This is a relatively common complication of acute or chronic pancreatitis. Sonography is essential for the diagnosis given its noninvasivity and availability. Other assessments that show the highest accuracy, specificity and sensitivity include MDCT and ERCP...
March 2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Ioannis Karoumpalis, Dimitrios K Christodoulou
Different types of benign or malignant cystic lesions can be observed in the pancreas. Pancreatic cystic lesions are classified under pathology terms into simple retention cysts, pseudocysts and cystic neoplasms. Mucinous cystic neoplasm is a frequent type of cystic neoplasm and has a malignant potential. Serous cystadenoma follows in frequency and is usually benign. Intraductal papillary mucinous neoplasms are the most commonly resected cystic pancreatic neoplasms characterized by dilated segments of the main pancreatic duct and/or side branches, the wall of which is covered by mucus secreting cells...
April 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Kim C Honselmann, Tobias Krauss, Sebastian Geserick, Ulrich F Wellner, Uwe Wittel, Ulrich T Hopt, Tobias Keck, Dirk Bausch
PURPOSE: The purpose of this study was to retrospectively evaluate diagnostic accuracy of cystic lesions of the pancreas in order to determine if less aggressive surgical treatment might be safe and therefore warranted. METHODS: A retrospective cohort study was conducted in 232 patients with either observed or resected cystic lesions of the pancreas referred for evaluation and treatment to the University Medical Center Freiburg, Germany, between 2001 and 2011. RESULTS: Most patients had MRI or CT for preoperative imaging (90...
June 2016: Langenbeck's Archives of Surgery
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