scholarly journals Serous microcystic adenoma of the head of the pancreas causing an obstructive jaundice

2008 ◽  
Vol 65 (11) ◽  
pp. 839-842 ◽  
Author(s):  
Radoje Colovic ◽  
Nikica Grubor ◽  
Marjan Micev ◽  
Vitomir Rankovic ◽  
Slavko Matic ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Complete Recovery ◽  
Postoperative Recovery ◽  
Venous Stasis ◽  
Abdominal Symptoms ◽  
Microcystic Adenoma ◽  
Whipple’S Procedure ◽  
Rare Benign Tumor ◽  
Distal Pancreas ◽  
Head Of The Pancreas

Background. Serous microcystic adenoma is a rare benign tumor of the exocrine pancreas originating from the ductal system and composed of a large number of small cysts covered by cuboid cells, filled with clear serous fluid and separated with fibrocolagenous stroma. Most frequently it appears in women in 7th and 8th decades, in the distal pancreas. It shows a very low malignant potential. In 2/3 of patients symptoms are uncharacteristic and in 1/3 they are absent. When localized within the head of the pancreas it rarely causes an obstructive jaundice. Case report. We presented a 61-year-old female patient who for months had had mild and nonspecific abdominal symptoms developing to progressive obstructive jaundice. At surgery we revealed a rather large policystic mass of the head of the pancreas causing not only obstructive jaundice but also a venous stasis by compression and dislocation of the portomesenteric vein. The tumor was removed with pylorus preserving cephalic duodenopancreatectomy (Whipple's procedure modified by Longmire-Traverso). Histology confirmed serous microcystic adenoma of the pancreas. The postoperative recovery was uneventful and preoperative symptoms disappeared. Conclusion. Although very rare, serous microcystic adenoma might appear within the head of the pancreas and has to be taken into consideration in differential diagnosis of cystic lesions of the head of the pancreas. Very rarely the tumour might cause obstructive jaundice. Surgical resection, which might be demanding, leads to complete recovery.

scholarly journals Acinar Cystic Transformation of the Pancreas: A Diagnostic Problem

2020 ◽  
Author(s):  
Mehmet Yildirim ◽  
Asuman Argon ◽  
Sedat Tan ◽  
Ahmet Cekic
Keyword(s):  
Benign Tumor ◽  
Pancreatic Tissue ◽  
Cystic Mass ◽  
Positive Staining ◽  
Abdominal Symptoms ◽  
Rare Benign Tumor ◽  
Head Of The Pancreas ◽  
Immunohistochemical Studies ◽  
Multiple Cysts ◽  
Macroscopic Examination

Acinar cystic transformation (ACT) or acinar cell cystadenoma is a rare benign tumor of the pancreas. Their clinical presentation is nonspecific, thus hampering their detection and frequently leading to misdiagnosis. In this report, we present a case of ACT of the pancreas in a 54-year-old man that was vague abdominal symptoms. A magnetic resonance imaging was shown a well-defined cystic mass located in the head of the pancreas, measuring 57×47×23 mm. Our patient was treated by pancreaticoduodenectomy. In the macroscopic examination of the mass, a multicystic lesion was found in cream-colored pancreatic tissue. Histological and immunohistochemical studies examination revealed a cystic mass containing multiple cysts at varying sizes, lined by epithelial cells without atypia and positive staining of CK7, CK8/18, and CK19. A high index of clinical suspicion is required to diagnose this tumor. The surgical approach is to ensure accurate diagnosis and to avoid complications

Impaired Fibrinolysis in Obstructive Jaundice - Evidence from Clinical and Experimental Studies

1988 ◽  
Vol 60 (01) ◽  
pp. 025-029 ◽  
Author(s):  
M Colucci ◽  
D F Altomare ◽  
G Chetta ◽  
R Triggiani ◽  
L G Cavallo ◽  
...  
Keyword(s):  
Renal Failure ◽  
Bile Duct ◽  
Obstructive Jaundice ◽  
Plasminogen Activator ◽  
Fibrinolytic Activity ◽  
Experimental Studies ◽  
Plasminogen Activator Inhibitor ◽  
Venous Stasis ◽  
Microvascular Thrombosis ◽  
Duct Ligation

SummaryMicrovascular thrombosis is considered an important pathogenetic factor in renal failure associated with obstructive jaundice but the mechanisms leading to fibrin deposition are still unknown. The plasma levels of plasminogen activator inhibitor (PAI) in 29 patients with obstructive jaundice were found significantly increased as compared to 20 nonjaundiced patients. Fibrin autography of plasma supplemented with tissue plasminogen activator (t-PA) revealed that in icteric samples most of the added activator migrated with an apparent Mr of 100 kDa, corresponding to t-PA-PAI complex, whereas in control samples virtually all t-PA migrated as free enzyme. PAI activity detected in icteric samples is similar to the endothelial type PAI since it is neutralized by a monoclonal antibody against PAI-1.Venous stasis in jaundiced patients was neither associated with an increase in blood fibrinolytic activity nor with a decrease in PAI activity. Immunologic assay showed that t-PA release was impaired in 3 out of 4 patients. In controls, venous occlusion induced an increase in both fibrinolytic activity and t-PA antigen and a reduction in PAI activity. Bile duct recanalization in jaundiced patients subjected to surgery was accompanied by a decrease in plasma PAI activity which paralleled the decrease in serum bilirubin levels. In nonjaundiced patients, surgical treatment did not cause significant changes in either parameter. Rabbits made icteric by bile duct ligation showed an early and progressive increase in plasma PAI activity indicating that obstructive jaundice itself causes the elevation of circulating PAI. It is concluded that obstructive jaundice is associated with a severe impairment of fibrinolysis which might contribute to microvascular thrombosis and renal failure.

scholarly journals Axial torsion and gangrene of Meckel’s diverticulum: Case report

2015 ◽  
Vol 143 (1-2) ◽  
pp. 79-82
Author(s):  
Sasa Radovic ◽  
Drago Albijanic ◽  
Marko Albijanic ◽  
Zoran Krstic
Keyword(s):  
Epigastric Pain ◽  
Ileocecal Valve ◽  
Postoperative Recovery ◽  
Normal Appearance ◽  
Abdominal Incision ◽  
Surgical Exploration ◽  
Axial Torsion ◽  
Abdominal Symptoms ◽  
Complete Physical Examination ◽  
Midline Abdominal Incision

Introduction. Meckel?s diverticulum (MD) is the most prevalent congenital anomaly of small intestine. It develops due to the incomplete obliteration of omphalomesenterict duct which normally undergoes obliteration during the seventh week of gestation. In the majority of cases MD is asymptomatic but it may cause various complications, such as bleeding, intestinal obstruction and inflammation. Cases of umbilical sinuses, fistulas and neoplasms related with MD have been reported, but extremely rare gangrene due to its axial torsion, especially in children, as is the case of our patients. Case Outline. An 11-year-old boy admitted to hospital due to 24 hours epigastric pain, vomiting and malaise. After a complete physical examination, and appropriate pre-surgical laboratory and radiographic tests, surgical exploration was performed with a midline abdominal incision. On 60th cm proximal to the ileocecal valve we found a long and in a narrow based ganrenous MD with axial torsion and fibrotic cord extending from the tip of MD to the ileal mesentery. Surrounding ileum had normal appearance. A demarcation and subsequent resection of MD and the surrounding ileum was performed with endto- end ileal anastomosis. Postoperative recovery was successful and the patient was discharged after six days. Conclusion. Axial torsion of MD is presented with non-specific abdominal symptoms and difficult preoperative diagnosis. The choice of diagnosis and therapy is surgical exploration and resection of MD.

scholarly journals Congenital or acquired? Obstructive jaundice in reoperated duodenal atresia

2019 ◽  
Vol 12 (8) ◽  
pp. e231021 ◽  
Author(s):  
Mervin Feng Ji Goh ◽  
Malcolm Han Wen Mak ◽  
Yee Low ◽  
Caroline Choo Phaik Ong
Keyword(s):  
Obstructive Jaundice ◽  
Intestinal Obstruction ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Abdominal Ultrasound ◽  
Postoperative Recovery ◽  
Duodenal Atresia ◽  
Emergency Laparotomy ◽  
Type I ◽  
Diagnostic Dilemma ◽  
Distal Common Bile Duct

A 55-day-old boy was transferred to our unit with intestinal obstruction and obstructive jaundice after two neonatal operations for duodenal atresia and intestinal malrotation. Abdominal ultrasound showed dilated intrahepatic and extrahepatic ducts with cut-off at the distal common bile duct (CBD). He underwent emergency laparotomy for adhesive intestinal obstruction with a contained abscess from mid-jejunal perforation. Biliary dissection was not attempted due to poor preoperative nutritional status. Tube cholecystostomy was created for biliary decompression. Postoperative magnetic resonance cholangiopancreatography showed dilated CBD with cut-off at the ampulla but did not demonstrate pancreaticobiliary maljunction (PBMJ). The diagnostic dilemma was whether our patient had congenital PBMJ or had developed biliary stricture from perioperative ischaemic scarring. He underwent definitive surgery at 7 months: excision of dilated CBD with Roux-en-Y hepaticojejeunal reconstruction, excisional tapering duodenoplasty and jejunostomy creation. Intraoperative finding was type I choledochal cyst and subsequently confirmed on histology. Postoperative recovery was uneventful and bilirubin levels normalised.

scholarly journals Obstructive Jaundice Induced by a True Cyst in the Head of the Pancreas

2014 ◽  
Vol 47 (11) ◽  
pp. 697-703
Author(s):  
Hiroki Aoyama ◽  
Yasuhiro Kurumiya ◽  
Ei Sekoguchi ◽  
Satoshi Kobayashi ◽  
Yasuyuki Fukami ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Head Of The Pancreas ◽  
True Cyst

scholarly journals Study of obstructive jaundice in adult: association between clinical diagnosis and operative "ndings

2019 ◽  
Vol 47 (1) ◽  
pp. 33-36
Author(s):  
Mohammad Golam Masum ◽  
ABM Sarwar Jahan ◽  
Md Rezwanul Haque Robbani ◽  
Fayed Chowdhuray ◽  
Mohammed Faroque Hossain
Keyword(s):  
Obstructive Jaundice ◽  
Clinical Diagnosis ◽  
Pancreatic Head ◽  
Serum Bilirubin Level ◽  
Female Ratio ◽  
Head Of The Pancreas ◽  
Average Rise ◽  
Operative Findings ◽  
Medical University ◽  
Male To Female

Obstructive jaundice is a condition in which there is blockage of the flow of bile out of the liver. To find out the correlation between clinical diagnosis and operative findings of patients having obstructive jaundice. This prospective observational study was conducted at the Department of Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from January 2008 to April 2009. Fifty clinically diagnosed obstructive jaundice cases were enrolled in this study. A detailed history was taken and thorough physical examination was done. Also necessary haematological, biochemical, radiological and other special investigations were carried out.  In this study, mean age of the patients was 42.9 years and male to female ratio was 1:1.17. The most frequent cause was choledocholithiasis (40%), stricture of CBD (6.0%), retained stone (14.0%), parasitic obstruction (4.0%), carcinoma (30.0%) and other cause (6.0%). Serum bilirubin level was below 10mg/dl in all cases of stricture of CBD. It was above 15mg/dL in cases of carcinoma head of the pancreas. The rise of Serum alkaline phosphates level was up to 3 folds in cases with choledocholithiasis, biliary stricture and pancreatic head malignancy. The average rise in other cases was 1 to 2 folds. Sensitivity and specificity of pre operative clinical diagnosis of choledocholithiasis, carcinoma and retain stone was 86.4 & 96.4%, 92.3 & 91.9% and 71.4 & 95.3% respectively. Pre operative clinical diagnosis of obstructive jaundice is a good diagnosis tool in diagnosis of causes of obstructive jaundice. Bangladesh Med J. 2018 Jan; 47 (1): 33-36

scholarly journals Congenital biliary web- a rare cause of obstructive jaundice in an infant: A case report

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Allah Ditta ◽  
Muhammad Bilal Mirza ◽  
Muhammad Waqas-ur-Rehman ◽  
Maria Fahim ◽  
Farrakh Mehmood Satar ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Hepatic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Tree ◽  
Postoperative Recovery ◽  
Common Hepatic Duct ◽  
Rare Entity ◽  
Case Presentation ◽  
Complete Obstruction ◽  
The Common

Background: Congenital biliary web of the extra-hepatic biliary tree is becoming exceedingly rare cause of obstructive jaundice in children. Case Presentation: We report a case of 5-month-old male baby who presented with acholic stools and persistent jaundice since birth. Magnetic resonance cholangiopancreatography (MRCP) showed contracted gall bladder and focal narrowing at mid portion of the common bile duct (CBD) with proximal dilatation of biliary channels. On exploration, a complete web was found just proximal to the confluence of cystic duct and common hepatic duct causing complete obstruction of biliary tree. A Roux-en-Y hepatico-jejunostomy was done. Postoperative recovery was uneventful. Conclusion: We conclude that congenital biliary web is a rare entity and should be considered in the dif­ferential diagnosis of biliary atresia.

Ectopic lacrimal gland in the lacrimal sac mimicking tumour: literature review

2020 ◽  
Vol 13 (7) ◽  
pp. e235187
Author(s):  
Athanasios Saratziotis ◽  
Claudia Zanotti ◽  
Maria Baldovin ◽  
Enzo Emanuelli
Keyword(s):  
Lacrimal Gland ◽  
Histopathological Examination ◽  
Drainage System ◽  
Surgical Excision ◽  
Complete Recovery ◽  
Postoperative Recovery ◽  
Endoscopic Approach ◽  
Lacrimal Sac ◽  
Chronic Dacryocystitis ◽  
Mri Scans

An 80-year-old man referred with repeated episode of dacryocystitis from the left lacrimal drainage system and palpable swelling. For many years, he has being presented with epiphora unilaterally with chronic dacryocystitis. Investigations with dye-test revealed subocclusion of the natural passage of the tears, and CT and MRI scans revealed solid mass in the lacrimal sac. The lacrimal sac was opened by endonasal endoscopic approach, the sacral mass was identified and completely removed. The histopathological examination showed lacrimal gland in ectopic position. Patient followed for 18 months with complete recovery of symptoms. In our differential diagnosis, the ectopic lacrimal gland is also identified, when a mass in the lacrimal sac and duct is present. Successful surgical excision required considerable multidisciplinary teamwork between ophtalmologist–ENT (Otolaryngologist) and radiologist. Endonasal endoscopic approach is perfectly safe with direct control and ensures a smooth postoperative recovery.

Combined Serous Microcystic Adenoma and Well-Differentiated Endocrine Pancreatic Neoplasm: A Case Report and Review of the Literature

2003 ◽  
Vol 127 (10) ◽  
pp. 1369-1372 ◽  
Author(s):  
Igor I. Slukvin ◽  
G. Reza Hafez ◽  
John E. Niederhuber ◽  
Thomas F. Warner
Keyword(s):  
Pancreatic Tumor ◽  
Pancreatic Neoplasm ◽  
Gastrointestinal Symptoms ◽  
Pancreatic Endocrine Neoplasm ◽  
Microcystic Adenoma ◽  
Younger Age ◽  
Women Literature ◽  
Head Of The Pancreas ◽  
Well Differentiated ◽  
Tomography Scan

Abstract We report a case of combined microcystic adenoma and pancreatic endocrine neoplasm of the pancreas in a 53-year-old male patient. The pancreatic tumor was an incidental computed tomography scan finding and was not accompanied by gastrointestinal symptoms. The tumor was located in the head of the pancreas and was composed of numerous small cysts lined by uniform clear cells with a centrally located solid endocrine component. Four cases of similar neoplasm have recently been reported, exclusively in women. Literature review and case analysis indicate that combined microcystic adenoma and pancreatic endocrine neoplasm is characterized by the presence of pancreatic endocrine neoplasm within microcystic adenoma in the head of the pancreas, affects women more often than men, and presents at a younger age when compared to microcystic adenoma.

Hydatid Cyst in the Head of the Pancreas with Obstructive Jaundice

1995 ◽  
Vol 20 (2) ◽  
pp. 136-138 ◽  
Author(s):  
Eric R. Lemmer ◽  
Jake E.J. Krige ◽  
Steven K. Price ◽  
Andrew H. Girdwood
Keyword(s):  
Obstructive Jaundice ◽  
Hydatid Cyst ◽  
Head Of The Pancreas
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