Rare Complication of Necrotizing Pancreatitis: Extension of Retroperitoneal Abscess into Femoral Region

Distant abscesses are uncommon during the episode of acute pancreatitis (AP). However, these are possible sequalae of necrotizing pancreatitis and should be treated appropriately to prevent serious septic complications. We demonstrate a case of a 56-year-old male patient who presented with severe necrotizing pancreatitis and distant retroperitoneal abscess that reached femoral region and was detected on diagnostic imaging scans. Combination of surgical and supportive therapy was employed, and the patient recovered well with no permanent consequences. Our article highlights the importance of quick and accurate diagnosis and timely intervention in this rare type of pancreatitis complication.

Download Full-text

Acute pancreatitis complicated by encephalopathy

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20202285 ◽

2020 ◽

Vol 8 (6) ◽

pp. 2319

Author(s):

Rajat Jhamb ◽

Anant Parasher ◽

Ashish Baweja

Keyword(s):

Acute Pancreatitis ◽

Supportive Care ◽

Male Patient ◽

Neurological Deficit ◽

Rare Complication ◽

Neurological Symptoms ◽

Metabolic Parameters ◽

Focal Neurological Deficit ◽

Altered Sensorium ◽

Pancreatic Encephalopathy

Pancreatic encephalopathy is a frequently under-diagnosed and rare complication of acute pancreatitis. It denotes the occurrence of neuropsychiatric abnormalities in the setting of acute pancreatic inflammation, and presents with neurological symptoms that may persist even after the resolution of all metabolic parameters. Here we present the case of a 42 year old male patient presenting with altered sensorium and focal neurological deficit during the course of acute pancreatitis. The patient was treated conservatively, and later improved with supportive care.

Download Full-text

Necroptosis protects against exacerbation of acute pancreatitis

Cell Death and Disease ◽

10.1038/s41419-021-03847-w ◽

2021 ◽

Vol 12 (6) ◽

Author(s):

Michittra Boonchan ◽

Hideki Arimochi ◽

Kunihiro Otsuka ◽

Tomoko Kobayashi ◽

Hisanori Uehara ◽

...

Keyword(s):

Acute Pancreatitis ◽

Necrotizing Pancreatitis ◽

Neutrophil Infiltration ◽

Dependent Manner ◽

Protective Effects ◽

Interacting Protein ◽

Inflammatory Conditions ◽

Edematous Pancreatitis ◽

Genetic Deletion ◽

Dose Dependent

AbstractThe sensing of various extrinsic stimuli triggers the receptor-interacting protein kinase-3 (RIPK3)-mediated signaling pathway, which leads to mixed-lineage kinase-like (MLKL) phosphorylation followed by necroptosis. Although necroptosis is a form of cell death and is involved in inflammatory conditions, the roles of necroptosis in acute pancreatitis (AP) remain unclear. In the current study, we administered caerulein to Ripk3- or Mlkl-deficient mice (Ripk3−/− or Mlkl−/− mice, respectively) and assessed the roles of necroptosis in AP. We found that Ripk3−/− mice had significantly more severe pancreatic edema and inflammation associated with macrophage and neutrophil infiltration than control mice. Consistently, Mlkl−/− mice were more susceptible to caerulein-induced AP, which occurred in a time- and dose-dependent manner, than control mice. Mlkl−/− mice exhibit weight loss, edematous pancreatitis, necrotizing pancreatitis, and acinar cell dedifferentiation in response to tissue damage. Genetic deletion of Mlkl resulted in downregulation of the antiapoptotic genes Bclxl and Cflar in association with increases in the numbers of apoptotic cells, as detected by TUNEL assay. These findings suggest that RIPK3 and MLKL-mediated necroptosis exerts protective effects in AP and caution against the use of necroptosis inhibitors for AP treatment.

Download Full-text

Familial Chylomicronemia Syndrome-Induced Acute Necrotizing Pancreatitis during Pregnancy

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0040-1722173 ◽

2021 ◽

Vol 43 (03) ◽

pp. 220-224

Author(s):

Julia Cristina Coronado Arroyo ◽

Marcio José Concepción Zavaleta ◽

Eilhart Jorge García Villasante ◽

Mikaela Kcomt Lam ◽

Luis Alberto Concepción Urteaga ◽

...

Keyword(s):

Acute Pancreatitis ◽

Pancreatic Necrosis ◽

Clinical Course ◽

Necrotizing Pancreatitis ◽

Rare Condition ◽

Severe Hypertriglyceridemia ◽

Fetal Complications ◽

Acute Necrotizing ◽

History Of ◽

Important Objective

AbstractAcute pancreatitis is a rare condition in pregnancy, associated with a high mortality rate. Hypertriglyceridemia represents its second most common cause. We present the case of a 38-year-old woman in the 24th week of gestation with a history of hypertriglyceridemia and recurrent episodes of pancreatitis. She was admitted to our hospital with acute pancreatitis due to severe hypertriglyceridemia. She was stabilized and treated with fibrates. Despite her favorable clinical course, she developed a second episode of acute pancreatitis complicated by multi-organ dysfunction and pancreatic necrosis, requiring a necrosectomy. The pregnancy was ended by cesarean section, after which three plasmapheresis sessions were performed. She is currently asymptomatic with stable triglyceride levels. Acute pancreatitis due to hypertriglyceridemia represents a diagnostic and therapeutic challenge in pregnant women, associated with serious maternal and fetal complications. When primary hypertriglyceridemia is suspected, such as familial chylomicronemia syndrome, the most important objective is preventing the onset of pancreatitis.

Download Full-text

Experience with Duodenal Necrosis: A Rare Complication of Acute Necrotizing Pancreatitis

International Journal of Gastrointestinal Cancer ◽

10.1385/ijgc:25:2:147 ◽

1999 ◽

Vol 25 (2) ◽

pp. 147-150 ◽

Cited By ~ 8

Author(s):

George H. Sakorafas ◽

Gregory G. Tsiotos ◽

Michael G. Sarr

Keyword(s):

Rare Complication ◽

Necrotizing Pancreatitis ◽

Acute Necrotizing Pancreatitis ◽

Acute Necrotizing

Download Full-text

Chordoid meningioma: report of two cases

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2003000100017 ◽

2003 ◽

Vol 61 (1) ◽

pp. 91-94 ◽

Cited By ~ 14

Author(s):

Oswaldo Ignácio de Tella Jr ◽

Marco Antonio Herculano ◽

Mirto Nelso Prandini ◽

João Norberto Stavile ◽

Antonio de Pádua Furquim Bonatelli

Keyword(s):

Ct Scan ◽

Male Patient ◽

Infratemporal Fossa ◽

Growth Patterns ◽

Partial Removal ◽

Rare Type ◽

Chordoid Meningioma ◽

First Case ◽

Pathologic Findings ◽

Histopathologic Findings

We present CT scan, MRI and histopathologic findings of two patients harboring a rare type of meningioma. In the first case, a 52 year-old male patient, a large parasellar mass invading the cavernous sinus, infiltrating the infratemporal fossa and extending as low as C2 was founded. The tumor was isointense on T1, enhanced strongly with gadolinium injection, and was hyperintense on T2. In the second case, a 19-year-old male patient, a large high density temporal right mass was disclosed by CT scan. Both patients were taken to surgery. In the first case, only a partial removal was possible to be accomplished due to a severe intra operative bleeding. In the second case, the tumor was totally removed. Both showed characteristic pathologic findings of a meningioma resembling a chordoma. Meningioma is a relatively common intracranial tumor, occurring most frequently in adults, showing a wide variety of growth patterns. We described a pattern that had a peculiar chordoma-like appearance. The pathological findings and the differential diagnosis from chordoma are discussed.

Download Full-text

The Management of Multi-Site, Bleeding, Visceral Artery Pseudoaneurysms, Secondary to Necrotising Pancreatitis

Annals of The Royal College of Surgeons of England ◽

10.1308/003588409x359295 ◽

2009 ◽

Vol 91 (3) ◽

pp. 255-258 ◽

Cited By ~ 2

Author(s):

J Skipworth ◽

D Raptis ◽

D Brennand ◽

C Imber ◽

A Shankar

Keyword(s):

Acute Pancreatitis ◽

Epigastric Pain ◽

Rare Complication ◽

Enterocutaneous Fistula ◽

Fistula Formation ◽

Visceral Artery ◽

Haemodynamic Instability ◽

Successful Recovery ◽

Necrotising Pancreatitis ◽

Tomographic Angiography

We present the case of a 45-year-old man, who presented to his local casualty department with severe epigastric pain following an alcohol binge, and was subsequently diagnosed with acute pancreatitis. Pancreatic necrosis with multiple collections ensued, necessitating transfer to an intensive care unit (ITU) in a tertiary hepatopancreaticobiliary centre. Initially, the patient appeared to slowly improve and was discharged to the ward, albeit following a prolonged ITU admission. However, during his subsequent recovery, he suffered multiple episodes of haematemesis and melaena associated with haemodynamic instability and requiring repeat admission to the ITU. Computerised tomographic angiography, followed by visceral angiography, was used to confirm the diagnosis of multisite visceral artery pseudoaneurysms, secondary to severe, necrotising pancreatitis. Pseudoaneurysms of the splenic, left colic and gastroduodenal arteries were sequentially, and successfully, radiologically embolised over a period of 9 days. Subsequent sequelae of radiological embolisation included a clinically insignificant splenic infarct, and a left colonic infarction associated with subsequent enterocutaneous fistula formation. The patient made a prolonged, but successful, recovery and was discharged from hospital after 260 days as an in-patient. This case illustrates the rare complication of three separate pseudoaneurysms, secondary to acute pancreatitis, successfully managed radiologically in the same patient. This case also highlights the necessity for multidisciplinary involvement in the management of pseudoaneurysms, an approach that is often most successfully achieved in a tertiary setting.

Download Full-text

Varied Ophthalmic Presentations in Sphenoid Sinus Lesions

Clinical Rhinology An International Journal ◽

10.5005/jp-journals-10013-1064 ◽

2011 ◽

Vol 4 (1) ◽

pp. 15-20

Author(s):

RG Aiyer ◽

Rahul Gupta ◽

Prarthna S Dhameja ◽

Virag Damania ◽

Abhishek Sharma ◽

...

Keyword(s):

Diagnostic Imaging ◽

Fungal Infection ◽

Sphenoid Sinus ◽

Imaging Techniques ◽

Accurate Diagnosis ◽

Team Approach ◽

Diagnosis And Management ◽

Ocular Manifestations ◽

Diagnostic Imaging Techniques

ABSTRACT Sphenoid sinus lesions can present with a multitude of symptoms/signs including ophthalmic disturbances. We describe a total of five patients, of which two had mucoceles and rest three had fungal infection. Ophthalmic symptoms/signs were the ones we were really interested in. We also present one case which had isolated sphenoid fungal sinus. We also give details of their presentation, investigations and treatment. Possible ocular manifestations of mucoceles and the diagnostic imaging techniques used are discussed. The treatment of mucoceles is reviewed. It is stressed that a team approach involving the ophthalmologist, otolaryngologist and radiologist is essential for accurate diagnosis and management.

Download Full-text