scholarly journals Acute Obstructive Suppuration of the Pancreatic Duct Causing Sepsis

2017 ◽  
Vol 31 (1&2) ◽  
pp. 20
Author(s):  
Stanley Yakubov ◽  
Jack Braha ◽  
Joel Albert ◽  
Rabin Rahmani ◽  
Ira Mayer ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Duct ◽  
English Literature ◽  
Recurrent Acute Pancreatitis ◽  
Laboratory Test Results ◽  
History Of ◽  
Pancreatic Ductal Obstruction ◽  
Pancreatic Duct Stones ◽  
Endoscopic Methods ◽  
Pigtail Stent

Objective: We report a rare case of acute obstructive suppuration of the pancreatic duct causing sepsis, which was successfully treated with emergent endoscopic retrograde cholangiopancreatography (ERCP). Methods: We describe the patient’s clinical presentation, laboratory test results, and imaging used for diagnosis and treatment. Results: A 33-year-old female with a history of recurrent acute pancreatitis was admitted during an episode of acute pancreatitis. Computed tomography (CT) scan of the abdomen revealed acute pancreatitis, diffuse pancreatic atrophy and pancreatic ductal dilatation with obstruction due to a soft tissue lesion within the distal duct. Shortly after admission she developed symptoms and signs of sepsis. Urgent ERCP was performed to further assess the suspected cholangitis. “Clean” bile emanated from the common bile duct, while copious purulent fluid was detected at the dilated pancreatic duct orifice, confirming suppuration of the pancreatic duct. A plastic single pigtail stent was placed traversing the ampulla and pancreatic duct stones that were causing the obstruction, which were later removed. After endoscopic decompression, the patient rapidly improved over the following 24 hours and had no subsequent admissions for pancreatitis.Conclusion: Acute suppuration of the pancreatic duct (ASPD) is a rare and potentially fatal infectious complication of pancreatic ductal obstruction with few cases reported in the English literature. It would be of interest to further investigate the exact pathophysiology leading to development of ASPD. The endoscopic methods of urgent ERCP and pancreatic duct decompression utilized in our case proved effective in successfully treating ASPD. This unusual condition should be considered in patients with acute pancreatitis who develop early clinical decompensation. 

scholarly journals The association of triglyceride levels with the incidence of initial and recurrent acute pancreatitis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Robert J. Sanchez ◽  
Wenzhen Ge ◽  
Wenhui Wei ◽  
Manish P. Ponda ◽  
Robert S. Rosenson
Keyword(s):  
Acute Pancreatitis ◽  
Medical Records ◽  
Adult Population ◽  
Baseline Period ◽  
Prior History ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Recurrent Acute Pancreatitis ◽  
History Of ◽  
Nationally Representative

Abstract Background This retrospective cohort study assessed the annualized incidence rate (IR) of acute pancreatitis (AP) in a nationally representative US adult population, as well as the variation in the risk of AP events across strata of triglyceride (TG) levels. Methods Data were obtained from IQVIA’s US Ambulatory Electronic Medical Records (EMR) database linked with its LRxDx Open Claims database. Inclusion criteria included ≥1 serum TG value during the overlapping study period of the EMR and claims databases, ≥1 claim in the 12-month baseline period, and ≥ 1 claim in the 12 months post index. All TG measurements were assigned to the highest category reached: < 2.26, ≥2.26 to ≤5.65, > 5.65 to ≤9.94, > 9.94, and > 11.29 mmol/L (< 200, ≥200 to ≤500, > 500 to ≤880, > 880, and > 1000 mg/dL, respectively). The outcome of interest was AP, defined as a hospitalization event with AP as the principal diagnosis. Results In total, 7,119,195 patients met the inclusion/exclusion criteria, of whom 4158 (0.058%) had ≥1 AP events in the prior 12 months. Most patients (83%) had TGs < 2.26 mmol/L (< 200 mg/dL), while < 1% had TGs > 9.94 mmol/L (> 880 mg/dL). Overall, the IR of AP was low (0.08%; 95% confidence internal [CI], 0.08–0.08%), but increased with increasing TGs (0.08% in TGs < 2.26 mmol/L [< 200 mg/dL] to 1.21% in TGs > 11.29 mmol/L [> 1000 mg/dL]). In patients with a prior history of AP, the IR of AP increased dramatically; patients with ≥2 AP events at baseline had an IR of 29.98% (95% CI, 25.1–34.9%). Conclusion The risk of AP increases with increasing TG strata; however, the risk increases dramatically among patients with a recent history of AP.

scholarly journals Colopancreatic Fistula: An Uncommon Complication of Recurrent Acute Pancreatitis

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Mouhanna Abu Ghanimeh ◽  
Omar Abughanimeh ◽  
Khalil Abuamr ◽  
Osama Yousef ◽  
Esmat Sadeddin
Keyword(s):  
Acute Pancreatitis ◽  
Alcohol Intake ◽  
Definitive Treatment ◽  
Watery Diarrhea ◽  
Endoscopic Retrograde ◽  
Recurrent Acute Pancreatitis ◽  
History Of ◽  
Acute And Chronic Pancreatitis ◽  
Heavy Alcohol Intake ◽  
Uncommon Complication

Colonic complications, including colopancreatic fistulas (CPFs), are uncommon after acute and chronic pancreatitis. However, they have been reported and are serious. CPFs are less likely to close spontaneously and are associated with a higher risk of complications. Therefore, more definitive treatment is required that includes surgical and endoscopic options. We present a case of a 62-year-old male patient with a history of heavy alcohol intake and recurrent acute pancreatitis who presented with a 6-month history of watery diarrhea and abdominal pain. His abdominal imaging showed a possible connection between the colon and the pancreas. A further multidisciplinary workup by the gastroenterology and surgery teams, including endoscopic ultrasound, endoscopic retrograde cholangiopancreatography, and colonoscopy, resulted in a diagnosis of CPF. A distal pancreatectomy and left hemicolectomy were performed, and the diagnosis of CPF was confirmed intraoperatively. The patient showed improvement afterward.

Endoscopic sphincterotomy (ES) may not alter the natural history of idiopathic recurrent acute pancreatitis (IRAP)

Pancreatology ◽  
2016 ◽  
Vol 16 (5) ◽  
pp. 770-777 ◽  
Author(s):  
Rohit Das ◽  
Bridger Clarke ◽  
Gong Tang ◽  
Georgios I. Papachristou ◽  
David C. Whitcomb ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Natural History ◽  
Endoscopic Sphincterotomy ◽  
Recurrent Acute Pancreatitis ◽  
History Of

347 Endoscopic Sphincterotomy (ES) May Not Alter the Natural History of Idiopathic Recurrent Acute Pancreatitis (IRAP)

2016 ◽  
Vol 83 (5) ◽  
pp. AB142
Author(s):  
Rohit Das ◽  
Bridger Clarke ◽  
Gong Tang ◽  
Georgios I. Papachristou ◽  
David C. Whitcomb ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Natural History ◽  
Endoscopic Sphincterotomy ◽  
Recurrent Acute Pancreatitis ◽  
History Of

scholarly journals Moderate Hypertriglyceridemia Causing Recurrent Pancreatitis: A Case Report and the Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Vijay Gayam ◽  
Amrendra Kumar Mandal ◽  
Pavani Garlapati ◽  
Mazin Khalid ◽  
Arshpal Gill ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Insulin Infusion ◽  
Term Treatment ◽  
Recurrent Acute Pancreatitis ◽  
Nasogastric Feeding ◽  
Long Term Treatment ◽  
History Of ◽  
Laboratory Investigations ◽  
Continuous Insulin Infusion

Recurrent acute pancreatitis secondary to hypertriglyceridemia (HTG) with levels below 1000 mg/dL has been rarely reported in the literature. HTG is the third most common cause of acute pancreatitis and has been established in the literature as a risk factor when levels are greater than 1000 mg/dL. A 43-year-old patient presented to the hospital with severe epigastric abdominal pain. Initial laboratory investigations were significant for a lipase level of 4143 U/L and a triglyceride level of 600 mg/dL. Computed tomography (CT) of the abdomen showed diffuse enlargement of the pancreas consistent with pancreatitis. A diagnosis of severe acute pancreatitis secondary to high triglycerides was made based on the revised Atlanta classification 2012. The patient was initially managed with intravenous boluses of normal saline followed by continuous insulin infusion. Diabetic Ketoacidosis (DKA) was ruled out due to a past medical history of diabetes. Her clinical course was complicated by acute respiratory distress syndrome requiring intubation and mechanical ventilation. During the course, she improved symptomatically and was extubated. She was started on nasogastric feeding initially and subsequently switched to oral diet as tolerated. After initial management of HTG with insulin infusion, oral gemfibrozil was started for long-term treatment of HTG. Emerging literature implicates HTG as an independent indicator of poor prognosis in acute pancreatitis (AP). Despite the paucity of data, the risk of developing AP must be considered even at triglyceride levels lower than 1000 mg/dL.

scholarly journals Eosinophilic Pancreatitis: A Rare Cause of Recurrent Acute Pancreatitis

2017 ◽  
Vol 11 (1) ◽  
pp. 120-126 ◽  
Author(s):  
Jennifer Reppucci ◽  
Michael Chang ◽  
Steven Hughes ◽  
Xiuli Liu
Keyword(s):  
Acute Pancreatitis ◽  
Immunoglobulin E ◽  
Elevated Serum ◽  
Peripheral Eosinophilia ◽  
Rare Form ◽  
Recurrent Acute Pancreatitis ◽  
History Of ◽  
Systemic Manifestations ◽  
Inflammatory Infiltrates ◽  
Pseudocyst Formation

Eosinophilic pancreatitis is a rare form of recurrent acute pancreatitis that demonstrates distinct histologic features, including diffuse, periductal, acinar, and septal inflammatory infiltrates comprised of a pure or predominant population of eosinophils, eosinophilic phlebitis and arteritis, and localized eosinophilic infiltrates with pseudocyst formation. It is associated with elevated serum immunoglobulin E levels, an elevated eosinophil count with systemic manifestations, and eosinophilic infiltrates in other organs of the gastrointestinal tract. We present a case of eosinophilic pancreatitis in a 44-year-old man who was diagnosed after pancreatic resection for recurrent bouts of acute pancreatitis. While the gross and histologic evaluations matched other reported cases of eosinophilic pancreatitis, our patient had only minimal peripheral eosinophilia, no reported history of symptoms related to elevated eosinophilia or immunoglobulin E, and only mild eosinophilic infiltrates in his gallbladder.

scholarly journals Recurrent Acute Pancreatitis Caused by a Gastric Duplication Cyst Communicating with an Aberrant Pancreatic Duct

2010 ◽  
Vol 49 (14) ◽  
pp. 1371-1375 ◽  
Author(s):  
Satoshi Oeda ◽  
Taiga Otsuka ◽  
Takumi Akiyama ◽  
Keisuke Ario ◽  
Masanori Masuda ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Duct ◽  
Duplication Cyst ◽  
Recurrent Acute Pancreatitis ◽  
Gastric Duplication ◽  
Gastric Duplication Cyst
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