scholarly journals Clinicopathological features of Pseudocyst Pancreas and its Management: A Prospective and Retrospective Study

2020 ◽  
Vol 6 (6) ◽  
pp. 338-346
Author(s):  
Dr. Mahim Koshariya ◽  
◽  
Dr. Agam Sharma ◽  
Dr. Brahmanand Gupta ◽  
Dr. Tushar Suroshe ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Clinicopathological Features ◽  
Alcoholic Pancreatitis ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic ◽  
Liquid Component ◽  
Large Size ◽  
History Of ◽  
Head Of The Pancreas ◽  
Surrounding Areas

Background: Revised Atlanta Classification has veered a change in our understanding ofpseudocyst pancreas which mandates renewed inquiry into pseudocysts defined as per new criteria.The present study provides an overview of experience with Pseudocyst Pancreas for over a decade.Methodology: 100 cases of pseudocysts diagnosed over the last 10 years at GMC, Bhopal,conforming to the present definition were reviewed. Cysts with the inhomogeneous collection,debris, necrosis, or any other non-liquid component, specifically in those diagnosed before 2012were excluded. Relevant data were analyzed. Results: The majority were male (85%) in the agegroup of 40-50 years with alcohol-induced chronic pancreatitis (77%) being the most frequentetiology. Abdominal pain (40%), lump (30%), and abdominal tenderness (59%) were common atpresentation. 58% were in the Head of the pancreas, 29% in the Neck and Body, and 13% in theTail and surrounding areas. Mean cyst diameter was 8.6cm and volume 252cc. 85% were managedsurgically and 40% of those managed conservatively also needed surgical intervention eventuallydue to complications. History of chronic alcoholic pancreatitis, the large size of the cyst (≥6cm and≥60cc), and communication with the main pancreatic duct were highly predictive of surgicalintervention. Conclusion: Radiological characteristics along with the clinical picture may suggestappropriate intervention. Surgery remains the principal modality of treatment, with high successrates.

scholarly journals Fistula of a pancreatic pseudocyst into the superior mesenteric and portal veins causing erythema nodosum and aseptic polyarthritis - case report and review of literature

2021 ◽  
pp. 43-43
Author(s):  
Nikica Grubor ◽  
Radoje Colovic ◽  
Cedomir Vucetic ◽  
Aleksandar Ninic ◽  
Dushan Atkinson
Keyword(s):  
Pancreatic Pseudocyst ◽  
Erythema Nodosum ◽  
Surgical Intervention ◽  
Pancreatic Disease ◽  
Alcoholic Pancreatitis ◽  
Fat Necrosis ◽  
Marrow Fat ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic ◽  
Portal Veins

Introduction. Extra-pancreatic complications of acute and chronic pancreatitis that do not relate to vital organs are rare. The most common include subcutaneous paniculitis, arthritis, bone marrow fat necrosis and vasculitis. These associated conditions have been termed Pancreatic Disease Syndrome (PDS), which can occur not only with pancreatitis but also in other pancreatic diseases. PDS is believed to be caused by circulating pancreatic enzymes, which can occur when the pancreas is in direct communication with the circulation. Pancreatic pseudocyst erosion into the superior mesenteric and portal veins is extremely rare; and there have only been 22 previously reported cases in literature. The authors endeavoured to describe a manifestation of PDS with formation of a pseudocystic-portal fistula, its complications, and propose adequate surgical management. Case outlin.e We present a 37-year-old man with chronic alcoholic pancreatitis and a pancreatic pseudocyst within the head of the pancreas which communicated with the main pancreatic duct on one side and eroded into the superior mesenteric and portal veins on the other, causing erythema nodosum-like vasculitis, and polyarthritis. The patient was initially treated conservatively, but subsequently required multiple arthrotomies and finally underwent pylorus preserving duodenopancreatectomy and direct repair of the affected veins. Conclusion. The majority of cases required aggressive surgical intervention due to heightened risk of hemorrhage. In patients who develop disseminated fat necrosis, an earlier surgical intervention can be justified. The authors would recommend that where practical a pylorus-preserving pancreaticoduodenectomy should be performed.

scholarly journals A case of splenic artery pseudoaneurysm rupture presenting as rectal bleeding in a regional hospital

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Jonathon N Holt ◽  
Heinrich E Schwalb
Keyword(s):  
Rectal Bleeding ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Regional Hospital ◽  
Alcoholic Pancreatitis ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic ◽  
Artery Pseudoaneurysm ◽  
Previous Trauma ◽  
Splenic Artery Pseudoaneurysm

Abstract Splenic artery pseudoaneurysm is a rare phenomenon most associated with chronic pancreatitis or previous trauma. Complications can include erosion and rupture into local structures, a situation that carries a reported mortality of 10–40%. A 58-year-old male with chronic alcoholic pancreatitis and a known splenic artery pseudoaneurysm presented to the emergency department of a regional hospital with rectal bleeding and sepsis. Computed tomography revealed a peri-splenic mass communicating with the splenic flexure. The patient was taken for an emergency splenectomy and left hemicolectomy and was confirmed to have rupture of the splenic artery aneurysm into the large bowel. This case presented with comparable features reported in the literature and demonstrates that access to emergency specialist surgical services in a regional setting offers the capability to manage rare, life threatening surgical emergencies.

Intraductal Papillary Mucinous Neoplasm of the Pancreas

2021 ◽  
Vol 8 (28) ◽  
pp. 2562-2566
Author(s):  
Jayalatha Nethagani ◽  
Priyanka Govula ◽  
Revathi Chandu ◽  
Pravin Raj T
Keyword(s):  
Epigastric Pain ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Uncinate Process ◽  
Cystic Lesions ◽  
Chronic Alcoholic ◽  
Contrast Enhanced ◽  
History Of ◽  
Head Of The Pancreas ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

A 36-year-old non-smoker, chronic alcoholic female presented with recurrent episodes of epigastric pain and vomiting in the last 10 days. H/o similar episodes of pain 3 times, with last episode was noted 2 months back. She also had history of vomiting (3 episodes). Jaundice/melena/steatorrheas was not observed. Subsequently, contrast-enhanced computed tomography (CECT) of the patient was done and it showed well defined multiple cystic lesions with peripheral wall enhancement involving head and body of pancreas, largest measuring 24 X 22 X 22 mm in the head of the pancreas, the lesion was seen abutting antro-pyloric region anteriorly. Main pancreatic is mildly dilated measuring 4 mm in diameter. A well-defined heterogeneously hypodense (necrotic) para duodenal lesion, was noted inferior to uncinate process, m/s 22 X 20 X 20 mm, which is indicative of lymph nodal deposit. On magnetic resonance cholangiopancreatography (MRCP): few cystic lesions were seen scattered in the pancreatic parenchyma, with one of the cysts showing communication with main pancreatic duct (MPD) ab.

Pathogenesis of pancreatic fibrosis in chronic alcoholic pancreatitis

1998 ◽  
Vol 114 ◽  
pp. A503
Author(s):  
T. Tanaka ◽  
T. Fujii ◽  
Y. Matsugu ◽  
Y. Kodoh ◽  
K. Koide ◽  
...  
Keyword(s):  
Pancreatic Fibrosis ◽  
Alcoholic Pancreatitis ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic

scholarly journals Nutritional profile of asymptomatic alcoholic patients

2011 ◽  
Vol 48 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Maria Beatriz Sobral-Oliveira ◽  
Joel Faintuch ◽  
Dulce Reis Guarita ◽  
Claudia P. Oliveira ◽  
Flair J. Carrilho
Keyword(s):  
Lean Body Mass ◽  
Body Mass ◽  
Alcoholic Pancreatitis ◽  
C Reactive Protein ◽  
Chronic Alcoholic Pancreatitis ◽  
Chronic Alcoholic ◽  
Vitamin Deficiencies ◽  
Reactive Protein ◽  
Amyloid A ◽  
Visceral Disease

CONTEXT: Alcoholism may interfere with nutritional status, but reports are often troubled by uncertainties about ingested diet and organ function, as well as by ongoing abuse and associated conditions. OBJECTIVE: To identify nutritional and body compartment changes in stable alcoholics without confounding clinical and dietetic variables, a prospective observational pilot study was designed. Three well-matched populations were considered: subjects with chronic alcoholic pancreatitis, alcoholics without visceral disease, and healthy never-drinking adults (controls). METHODS: Subjects (n = 60) were asymptomatic males with adequate diet, no superimposed disease or complication, and alcohol-free for at least 6 months. After exclusions, 48 patients were compared. Variables encompassed dietary recall, bioimpedance analysis, biochemical profile and inflammatory markers. Main outcome measures were body fat, lean body mass, serum lipids, C-reactive protein, and selected minerals and vitamins. RESULTS: Both alcoholic populations suffered from reduced lean body mass (P = 0.001), with well-maintained body fat.Magnesium was depleted, and values of vitamin D and B12 correlated with alcohol abuse. LDL and total cholesterol was increased in alcoholics without pancreatitis (P = 0.04), but not in those with visceral damage. C-reactive protein and serum amyloid A correlated with duration of excessive drinking (P = 0.01). CONCLUSIONS: Undernutrition (diminished lean body mass, risk of magnesium and vitamin deficiencies) contrasted with dyslipidemia and increased cardiovascular risk. This second danger was masked during chronic pancreatitis but not in alcoholics without visceral disease. Further studies should focus special requirements of this population.

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