Chronic Obstructive Pancreatitis as a Delayed Complication of Pancreatic Trauma

Increasing surgical experience with the immediate consequences of pancreatic injuries has resulted from parallel growth in the volume of motor vehicle accidents and societal violence. However, few surgeons are aware that complications may be considerably delayed following pancreatic trauma, occurring in some cases months to years after apparent recovery from the original injury. In four patients with blunt pancreatic trauma initially treated by non-operative means, stricture of the main pancreatic duct developed over a period of months as a result of progressive fibrosis at the site of ductal injury. Pancreatic duct hypertension was demonstrated to be present in the obstructed duct, and secondary changes of chronic pancreatitis developed in the obstructed segment of the gland (“upstream” chronic pancreatitis). Seven similar patients with delayed onset of chronic obstructive pancreatitis after pancreatic trauma were found in the literature. Symptoms related to these acquired ductal strictures are most commonly those of abdominal pain and recurrent episodes of acute pancreatitis. Recognition of post-traumatic chronic obstructive pancreatitis principally involves awareness that injuries to the pancreatic duct can produce remote complications. Pancreatoenteric drainage, or resection of the obstructed segment of pancreas, provides prompt and effective relief.

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Chronic obstructive pancreatitis due to a pancreatic cyst in a patient with autosomal dominant polycystic kidney disease

Gut ◽

10.1136/gut.42.1.131 ◽

1998 ◽

Vol 42 (1) ◽

pp. 131-134 ◽

Cited By ~ 15

Author(s):

D Malka ◽

P Hammel ◽

V Vilgrain ◽

J-F Fléjou ◽

J Belghiti ◽

...

Keyword(s):

Kidney Disease ◽

Pancreatic Duct ◽

Polycystic Kidney Disease ◽

Main Pancreatic Duct ◽

Autosomal Dominant ◽

Pancreatic Cyst ◽

Chronic Obstructive ◽

Polycystic Kidney ◽

Obstructive Pancreatitis ◽

Autosomal Dominant Polycystic Kidney

Background—Autosomal dominant polycystic kidney disease, the most frequent inherited polycystic disease, is a systemic disorder characterised by the development of numerous and bilateral kidney cysts leading to chronic renal failure. Extrarenal cysts are located mainly in the liver but also in various organs including the pancreas. To our knowledge, complications of pancreatic cysts in this disease have never been reported.Patient—The first case of painful chronic obstructive pancreatitis due to a true pancreatic cyst in a patient with autosomal dominant polycystic kidney disease is reported. Abdominal transparietal and endoscopic ultrasonography, computed tomography, and endoscopic retrograde cholangiopancreatography showed a cystic lesion in the body of the pancreas associated with upstream dilatation of the main pancreatic duct. Intraoperative ultrasonography before and after cyst fluid aspiration, and pancreatography and pathological examination of the resected distal pancreas confirmed that both main pancreatic duct enlargement and chronic pancreatitis were caused by a benign cyst.Conclusion—Chronic obstructive pancreatitis should be added to the extrarenal complications of autosomal dominant polycystic kidney disease.

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Compartment syndrome in experimental chronic obstructive pancreatitis: Effect of decompressing the main pancreatic duct

British Journal of Surgery ◽

10.1002/bjs.1800810236 ◽

1994 ◽

Vol 81 (2) ◽

pp. 259-264 ◽

Cited By ~ 96

Author(s):

N. D. Karanjia ◽

A. L. Widdison ◽

F. Leung ◽

C. Alvarez ◽

F. J. Lutrin ◽

...

Keyword(s):

Pancreatic Duct ◽

Compartment Syndrome ◽

Main Pancreatic Duct ◽

Chronic Obstructive ◽

Obstructive Pancreatitis

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Mucinous cystadenoma of pancreatic head with focal malignant alteration in a 52-year old man

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0704204c ◽

2007 ◽

Vol 135 (3-4) ◽

pp. 204-207

Author(s):

Radoje Colovic ◽

Marjan Micev ◽

Vladimir Radak ◽

Nikica Grubor ◽

Mirjana Stojkovic ◽

...

Keyword(s):

Pancreatic Duct ◽

Mucinous Cystadenoma ◽

Pancreatic Head ◽

Postoperative Recovery ◽

The Body ◽

Chronic Obstructive ◽

Obstructive Pancreatitis ◽

Head Of The Pancreas ◽

Malignant Alteration ◽

Mucinous Cystadenomas

Mucinous cystadenomas of the pancreas are rare tumors appearing usually within the body and the tail of the pancreas in a young and middle-aged women. They rarely communicate with the pancreatic duct and occasionally may become malignant. The authors present a patient with a number of rare features. In a 52 year-old male, we did a radical pylorus-preserving cephalic duodenopancreatectomy for a mucinous cystadenoma within the head of the pancreas, which perforated into the main pancreatic duct causing chronic obstructive pancreatitis having few foci of malignant alteration. The postoperative recovery was uneventful, but three months later the patient died due to exacerbation of the underlying serious heart disease. .

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Pancreaticopleural fistula: an uncommon cause of amylase-rich pleural effusion

BMJ Case Reports ◽

10.1136/bcr-2020-236232 ◽

2020 ◽

Vol 13 (8) ◽

pp. e236232

Author(s):

Valeri Kraskovsky ◽

Brianne Mackenzie ◽

Martin Jeffery Mador

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Chronic Pancreatitis ◽

Pleural Effusion ◽

Pancreatic Duct ◽

Chronic Obstructive ◽

Endoscopic Retrograde ◽

Obstructive Pulmonary Disease ◽

Rare Finding ◽

Fluid Analysis ◽

Exudative Pleural Effusion

Pancreaticopleural fistula (PPF) causing pleural effusion as a complication of chronic pancreatitis is a rare finding. We present this finding in a 52-year-old man with a medical history significant for alcohol abuse, acute on chronic pancreatitis and severe chronic obstructive pulmonary disease, who presented with worsening dyspnoea for 3 days. CT scan of the chest showed a new large right-sided pleural effusion. Thoracentesis was performed and pleural fluid analysis showed an amylase-rich, exudative pleural effusion. The effusion reaccumulated within 3 days necessitating repeat thoracentesis. Endoscopic retrograde chloangiopancreatography showed contrast leak through a single disruption in the dorsal pancreatic duct, suspicious for an underlying PPF. The patient underwent stenting of the pancreatic duct with subsequent resolution of right-sided pleural effusion.

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Feline Model of Chronic Obstructive Pancreatitis: Effects of Acute Pancreatic Duct Decompression on Blood Flow and Interstitial pH

Scandinavian Journal of Gastroenterology ◽

10.1080/003655299750026489 ◽

1999 ◽

Vol 34 (4) ◽

pp. 439-444 ◽

Cited By ~ 19

Author(s):

P. U. Reber, A. G. Patel, M. T. Toy

Keyword(s):

Blood Flow ◽

Pancreatic Duct ◽

Chronic Obstructive ◽

Obstructive Pancreatitis ◽

Feline Model

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A Reassessment of Suicide Measurement

Crisis ◽

10.1027/0227-5910.30.1.6 ◽

2009 ◽

Vol 30 (1) ◽

pp. 6-12 ◽

Cited By ~ 3

Author(s):

D.P. Doessel ◽

Ruth F.G. Williams ◽

Harvey Whiteford

Keyword(s):

Causes Of Death ◽

Motor Vehicle ◽

Years Of Life Lost ◽

Health Prevention ◽

Prevention Strategies ◽

Vehicle Accidents ◽

The Social ◽

Evaluation Exercise ◽

Two Measures ◽

Circulatory Diseases

Background. Concern with suicide measurement is a positive, albeit relatively recent, development. A concern with the social loss from suicide requires careful attention to appropriately measuring the phenomenon. This paper applies two different methods of measuring suicide data: the conventional age-standardized suicide (count) rate; and the alternative rate, the potential years of life lost (PYLL) rate. Aims. The purpose of applying these two measures is to place suicide in Queensland in a historical and comparative (relative to other causes of death) perspective. Methods. Both measures are applied to suicide data for Queensland since 1920. These measures are applied also to two largish causes of death and two smaller causes of death, i.e., circulatory diseases, cancers, motor vehicle accidents, suicide. Results. The two measures generate quite different pictures of suicide in Queensland: Using the PYLL measure, suicide is a quantitatively larger issue than is indicated by the count measure. Conclusions. The PYLL measure is the more appropriate measure for evaluation exercise of public health prevention strategies. This is because the PYLL measure is weighted by years of life lost and, thus, it incorporates more information than the count measure which implicitly weights each death with a somewhat partial value, viz. unity.

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