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https://www.readbyqxmd.com/read/29778250/surgical-management-of-intraductal-papillary-mucinous-neoplasm-with-main-duct-involvement-an-international-expert-survey-and-case-vignette-study
#1
Lianne Scholten, Nadine C M van Huijgevoort, Marco J Bruno, Carlos Fernandez-Del Castillo, Sohei Satoi, Alain Sauvanet, Christopher Wolfgang, Paul Fockens, Suresh T Chari, Marco Del Chiaro, Jeanin E van Hooft, Marc G Besselink
BACKGROUND: The risk of invasive cancer in resected intraductal papillary mucinous neoplasm with main pancreatic duct involvement is 33%-60%. Most guidelines, therefore, advise resection of main duct intraductal papillary mucinous neoplasm and mixed type intraductal papillary mucinous neoplasm in surgically fit patients, although advice on the surgical strategy (partial or total pancreatectomy) differs. We performed a survey amongst international experts to guide the design of future studies and help to prepare for a single international set of guidelines...
May 16, 2018: Surgery
https://www.readbyqxmd.com/read/29774088/endoscopic-ultrasound-guided-drainage-of-pancreatic-walled-off-necrosis-using-self-expanding-metal-stents-without-fluoroscopy
#2
Barbara Braden, Andreas Koutsoumpas, Michael A Silva, Zahir Soonawalla, Christoph F Dietrich
AIM: To investigate whether endoscopic ultrasound (EUS)-guided insertion of fully covered self-expandable metal stents in walled-off pancreatic necrosis (WOPN) is feasible without fluoroscopy. METHODS: Patients with symptomatic pancreatic WOPN undergoing EUS-guided transmural drainage using self-expandable and fully covered self expanding metal stents (FCSEMS) were included. The EUS visibility of each step involved in the transmural stent insertion was assessed by the operators as "visible" or "not visible": (1) Access to the cyst by needle or cystotome; (2) insertion of a guide wire; (3) introducing of the diathermy and delivery system; (4) opening of the distal flange; and (5) slow withdrawal of the delivery system until contact of distal flange to cavity wall...
May 16, 2018: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29751790/obliterative-cholangiopathy-in-acquired-cystic-biliary-atresia-type-iii-after-cyst-perforation-a-case-report
#3
Tsugumichi Koshinaga, Kensuke Ohashi, Kakou Ono, Hide Kaneda, Takeshi Furuya
BACKGROUND: In biliary atresia, the disease process of obliterative cholangiopathy may begin in the perinatal period; however, no chronological evidence exists on how the cholangiopathy progresses to biliary obliteration. This is the first acquired case with the final diagnosis of type III cystic biliary atresia with an extrahepatic biliary cyst which showed the progression of obliterative cholangiopathy in chronological order after birth. CASE PRESENTATION: An 81-day-old girl presented with acute abdominal distress due to bilious peritonitis caused by biliary cyst perforation, for which she underwent emergency biliary drainage...
May 11, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29730906/predictors-of-malignancy-in-pure-branch-duct-intraductal-papillary-mucinous-neoplasm-of-the-pancreas-without-enhanced-mural-nodules-on-ct-imaging-a-nationwide-multicenter-study
#4
Tae Hyeon Kim, Young Sik Woo, Hyung Ku Chon, Jin Hyeok Hwang, Kyo Sang Yoo, Woo Jin Lee, Kwang Hyuck Lee, Jong Kyun Lee, Seok Ho Dong, Chang Hwan Park, Eun Taek Park, Jong Ho Moon, Ho Gak Kim, Kwang Bum Cho, Hong Ja Kim, Seung Ok Lee, Young Koog Cheon, Jeong-Mi Lee, Jin Woo Park, Myung-Hwan Kim
Background/Aim: Enhanced mural nodules, which can be visualized using computed tomography (CT), constitute high-risk stigmata in branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs). Conversely, the absence of enhanced mural nodules on preoperative imaging does not exclude malignant risk. The present study aimed to investigate other morphological features as predictors of malignancy in "pure" BD-IPMNs without enhanced mural nodules on CT. Method: This retrospective study included 180 patients with surgically confirmed "pure" BD-IPMNs of the pancreas and no enhanced mural nodules on preoperative CT...
May 4, 2018: Gut and Liver
https://www.readbyqxmd.com/read/29725534/middle-segment-pancreatectomy-for-a-solid-serous-cystadenoma-diagnosed-by-mrcp-and-review-of-the-literature-a-case-report
#5
Yuichiro Okumura, Takehiro Noda, Hidetoshi Eguchi, Yoshifumi Iwagami, Daisaku Yamada, Tadafumi Asaoka, Koichi Kawamoto, Kunihito Gotoh, Shogo Kobayashi, Koji Umeshita, Yasuji Hashimoto, Yutaka Takeda, Masahiro Tanemura, Minoru Shigekawa, Eiichi Morii, Tetsuo Takehara, Masaki Mori, Yuichiro Doki
Solid serous cystadenoma of the pancreas is the rarest subtype of serous cystadenoma. Cystic structures are difficult to recognize by imaging studies. In the clinical setting, it is crucial to discriminate a solid serious cystadenoma from other solid pancreatic tumors. The present study reported a case of solid serous cystadenoma in which the magnetic resonance cholangiopancreatography (MRCP) findings were useful for diagnosis and decision-making regarding the surgical strategy, with a review of the previous reports of solid serous cystadenoma...
May 2018: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29713252/quantitative-proteomic-analysis-of-pancreatic-cyst-fluid-proteins-associated-with-malignancy-in-intraductal-papillary-mucinous-neoplasms
#6
Misol Do, Dohyun Han, Joseph Injae Wang, Hyunsoo Kim, Wooil Kwon, Youngmin Han, Jin-Young Jang, Youngsoo Kim
Background: The application of advanced imaging technologies for identifying pancreatic cysts has become widespread. However, accurately differentiating between low-grade dysplasia (LGD), high-grade dysplasia (HGD), and invasive intraductal papillary mucinous neoplasms (IPMNs) remains a diagnostic challenge with current biomarkers, necessitating the development of novel biomarkers that can distinguish IPMN malignancy. Methods: Cyst fluid samples were collected from nine IPMN patients (3 LGD, 3 HGD, and 3 invasive IPMN) during their pancreatectomies...
2018: Clinical Proteomics
https://www.readbyqxmd.com/read/29703250/a-case-report-of-giant-pancreatic-pseudocyst-following-acute-pancreatitis-experience-with-endoscopic-internal-drainage
#7
W A E Udeshika, H M M T B Herath, S U B Dassanayake, S P Pahalagamage, Aruna Kulatunga
BACKGROUND: Pancreatic cysts are being diagnosed more frequently because of the increasing usage of imaging techniques. A pseudocyst with the major diameter of 10 cm is termed as a giant cyst. Asymptomatic pseudo-cysts up to 6 cm in diameter can be safely observed and monitored without intervention, but larger and symptomatic pseudocysts require intervention. CASE PRESENTATION: A 27-year-old Sri Lankan male, with history of heavy alcohol use, presented with progressive abdominal distension following an episode of acute pancreatitis...
April 27, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29693047/pancreatic-hif2%C3%AE-stabilization-leads-to-chronic-pancreatitis-and-predisposes-to-mucinous-cystic-neoplasm
#8
Heather K Schofield, Manuj Tandon, Min-Jung Park, Christopher J Halbrook, Sadeesh K Ramakrishnan, Esther C Kim, Jiaqi Shi, M Bishr Omary, Yatrik M Shah, Farzad Esni, Marina Pasca di Magliano
Background & Aims: Tissue hypoxia controls cell differentiation in the embryonic pancreas, and promotes tumor growth in pancreatic cancer. The cellular response to hypoxia is controlled by the hypoxia-inducible factor (HIF) proteins, including HIF2α. Previous studies of HIF action in the pancreas have relied on loss-of-function mouse models, and the effects of HIF2α expression in the pancreas have remained undefined. Methods: We developed several transgenic mouse models based on the expression of an oxygen-stable form of HIF2α, or indirect stabilization of HIF proteins though deletion of von Hippel-Lindau, thus preventing HIF degradation...
2018: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29692941/pancreatic-hydatid-cyst-causing-acute-pancreatitis-a-case-report-and-literature-review
#9
Bayan Alsaid, Maryam Alhimyar, Fadi Rayya
Hydatidosis is a public health problem in endemic countries. Hydatid cysts are located usually in the liver and the lungs. Primary pancreatic hydatid cyst is in unusual location and rarely causes acute pancreatitis. In this paper, we report a case of a 34-year-old man who admitted with recurrent acute pancreatitis. Following the preoperation investigations, the primary impression was a pancreatic pseudocyst. During surgery, a primary hydatid cyst was detected in the pancreas measuring 35 × 20 × 15 cm. The treatment consisted of evacuation and external draining of the cyst...
2018: Case Reports in Surgery
https://www.readbyqxmd.com/read/29690869/concurrent-presentation-of-an-intraductal-tubulopapillary-neoplasm-and-intraductal-papillary-mucinous-neoplasm-in-the-branch-duct-of-the-pancreas-with-a-superior-mesenteric-artery-aneurysm-a-case-report
#10
Kenta Inomata, Minoru Kitago, Hideaki Obara, Yoko Fujii-Nishimura, Masahiro Shinoda, Hiroshi Yagi, Yuta Abe, Taizo Hibi, Kentaro Matsubara, Go Oshima, Yasuhito Sekimoto, Masazumi Inoue, Osamu Itano, Michiie Sakamoto, Yuko Kitagawa
BACKGROUND: Since the concept of intraductal tubulopapillary neoplasm (ITPN) was introduced in the current World Health Organization classification of tumors, the number of reports of ITPN occurrence has increased gradually. However, ITPN is usually located in the main pancreatic duct, with few reports of a branch duct ITPN. As a result, imaging protocols for the diagnosis of a branch duct ITPN have not been established. CASE PRESENTATION: We report a case of a concurrent presentation of a branch duct ITPN and intraductal papillary mucinous neoplasm (IPMN) in the head of the pancreas, with a superior mesenteric artery (SMA) aneurysm...
April 24, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29686910/cystic-lymphangioma-are-triglycerides-always-measurable
#11
Silke François, Manuella Martin, Olivier Costa, Daniel Urbain, Fazia Mana
The presence of chylous fluid with high triglycerides levels on endoscopic ultrasound- (EUS-) guided fine needle aspiration (FNA) is very pathognomonic for the diagnosis of cystic lymphangiomas of the pancreas. In our case report the puncture of the pancreatic cyst showed a typical milky fluid though measurable triglyceride concentrations were absent in the laboratory. Two possible explanations were found. First of all grossly lipemic samples show a slower rate of color development than do clear serums which can produce a false negative result if the sample is insufficiently diluted...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29685673/multifocal-cysts-and-incidence-of-pancreatic-cancer-concomitant-with-intraductal-papillary-mucinous-neoplasm
#12
Takuya Ikegawa, Atsuhiro Masuda, Arata Sakai, Hirochika Toyama, Yoh Zen, Keitaro Sofue, Takashi Nakagawa, Hideyuki Shiomi, Mamoru Takenaka, Takashi Kobayashi, Masaru Yoshida, Yoshifumi Arisaka, Yoshihiro Okabe, Hiromu Kutsumi, Takumi Fukumoto, Takeshi Azuma
OBJECTIVES: The present study was conducted in order to elucidate the relationship between the number of cyst-existing regions and incidence of pancreatic ductal adenocarcinoma (PDAC) concomitant with intraductal papillary mucinous neoplasm (IPMN), which currently remains unclear. METHODS: Subjects comprised 141 patients undergoing resection for IPMN (Non-invasive IPMN (IPMN with low-to high-grade dysplasia): N = 94, invasive IPMN: N = 31, and PDAC concomitant with IPMN: N = 16) between November 2000 and February 2017...
April 13, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29685110/wirsung-atraumatic-rupture-in-patient-with-pancreatic-pseudocysts-a-case-presentation
#13
Martino Gerosa, Marco Chiarelli, Angelo Guttadauro, Matilde De Simone, Fulvio Tagliabue, Melchiorre Costa, Sabina Terragni, Ugo Cioffi
BACKGROUND: Pancreatic duct disruption is a challenging condition leading to pancreatic juice leakage and consequently to pancreatic fluid collections. The manifestations of pancreatic main duct leak include pseudocysts, walled-off necrosis, pancreatic fistulas, ascites, pleural and pericardial effusions. Pseudocyst formation is the most frequent outcome of a pancreatic duct leak. CASE PRESENTATION: We describe a case of a 64-year old man with large multiple pancreatic cysts discovered for progressive jaundice and significant weight loss in the absence of a previous episode of acute pancreatitis...
April 23, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29683970/endoscopic-ultrasound-based-pancreatic-cancer-screening-of-high-risk-individuals-a-prospective-observational-trial
#14
Alexandra Gangi, Mokenge Malafa, Jason Klapman
OBJECTIVES: Pancreatic cancer (PC), a common cause of cancer death, is rarely diagnosed at an early stage. Early detection of PC may improve outcomes in affected patients. This study evaluated the utility of screening of high-risk individuals (HRIs) using an endoscopic ultrasound (EUS)-only approach to detect early malignant changes. METHODS: A prospective PC screening program for HRIs was opened in 2007. Fifty-eight patients have enrolled to date. Patients with normal EUS examinations underwent repeat EUS annually for 5 years...
April 19, 2018: Pancreas
https://www.readbyqxmd.com/read/29683969/diagnostic-accuracy-of-preoperative-imaging-for-differentiation-of-branch-duct-versus-mixed-duct-intraductal-papillary-mucinous-neoplasms
#15
Emmanuel E Ugbarugba, Carmen Grieco, Phil A Hart, Feng Li, Brett Sklaw, Kevin Cronley, Veeral M Oza, Benjamin J Swanson, Jon P Walker, Samer El-Dika, Darwin L Conwell, Somashekar G Krishna
OBJECTIVE: The aim of this study is to determine the diagnostic accuracy of preoperative evaluation to detect main pancreatic duct involvement in pancreatic cystic lesions thus differentiating mixed intraductal papillary mucinous neoplasm (IPMN) from branch duct (BD)-IPMN. METHODS: The pathology database of pancreatic resections from 2000 to 2014 was reviewed. Main pancreatic duct-IPMNs and IPMNs with intracystic mass/nodules were excluded. The preoperative test characteristics were analyzed using surgical histopathology as the "gold standard...
May 2018: Pancreas
https://www.readbyqxmd.com/read/29660844/moray-micro-forceps-biopsy-improves-the-diagnosis-of-specific-pancreatic-cysts
#16
M Lisa Zhang, Ronald N Arpin, William R Brugge, David G Forcione, Omer Basar, Martha B Pitman
BACKGROUND: Making a specific diagnosis of pancreatic cysts preoperatively is difficult. The new disposable Moray micro forceps biopsy (MFB) device allows tissue sampling from the pancreatic cyst wall/septum and aims to improve diagnosis. This study compares the diagnostic performance of the MFB with the current conventional analysis of pancreatic cyst fluid (PCF). METHODS: A total of 48 patients sampled with MFB were identified. Cysts were classified as mucinous on PCF based on extracellular mucin/mucinous epithelium, carcinoembryonic antigen (CEA) levels ≥192 ng/mL, or KRAS/GNAS mutation...
April 16, 2018: Cancer Cytopathology
https://www.readbyqxmd.com/read/29629700/isolated-mediastinal-pseudocyst-of-the-pancreas
#17
Pankaj Halder, Kartik Chandra Mandal, Bidyut Debnath, Sumedha Mukherjee
BACKGROUND: Mediastinal pancreatic pseudocyst is a rare complication of pancreatitis. CASE CHARACTERISTICS: An 8-year-old boy with chest pain and shortness of breath. Computed tomography of chest showed a cystic mass in the mediastinum. The cyst aspirate revealed high amylase and lipase levels, suggestive of pancreatic pseudocyst. OUTCOME: The patient gradually recovered after Roux-en-Y cystojejunostomy. MESSAGE: Cysto-jejunostomy is a viable treatment option for mediastinal pancreatic pseudocyst, especially with failure of medical therapy...
March 15, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29626802/laparoscopic-excision-of-a-retroperitoneal-completely-isolated-enteric-duplication-cyst-in-an-adult-male-a-case-report-and-review-of-literature
#18
Naoya Sasaki, Miru Okamura, Satoshi Kanto, Kentaro Tatsumi, Seiichi Yasuda, Atsushi Kawabe
INTRODUCTION: Duplication cysts are very rare congenital malformations in adults. They are lined by gastrointestinal mucosa, connect to the digestive tract, and share smooth muscular layers and a common blood supply. In rare cases, duplication cysts are completely isolated from the digestive tract and have a proper blood supply. Completely isolated duplication cysts in the retroperitoneum are unusual so it is hard to diagnose them without a surgical resection. PRESENTATION OF CASE: A 19-year-old male presented at our emergency department with sharp abdominal pain...
March 28, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29610514/continuing-medical-education-questions-april-2018-acg-clinical-guideline-diagnosis-and-management-of-pancreatic-cysts
#19
Steven L Carpenter
No abstract text is available yet for this article.
April 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29606939/laparoscopic-resection-of-an-epithelial-cyst-in-an-intrapancreatic-accessory-spleen
#20
REVIEW
Kazuhiro Suzumura, Etsuro Hatano, Toshihiro Okada, Yasukane Asano, Naoki Uyama, Ikuo Nakamura, Seikan Hai, Nobutaka Ichikawa, Keiji Nakasho, Jiro Fujimoto
An epithelial cyst in an intrapancreatic accessory spleen (ECIAS) is rare. We herein report a case of a patient with ECIAS who underwent laparoscopic surgery. A 57-year-old woman was referred to our hospital because of a pancreatic tail tumor. She was asymptomatic, and a physical examination revealed no remarkable abnormalities. The levels of the tumor marker carbohydrate antigen 19-9 (CA19-9) and s-pancreas-1 antigen (SPan-1) were elevated. Ultrasonography showed a well-defined homogeneous cystic tumor. Computed tomography showed a well-demarcated cystic tumor in the pancreatic tail...
September 2017: Case Reports in Gastroenterology
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