pancreatic pseudocyst
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Digestion ◽  
2022 ◽  
pp. 1-9
Author(s):  
Daxin Guo ◽  
Wei Dai ◽  
Jingyi Shen ◽  
Mengting Zhang ◽  
Yetan Shi ◽  
...  

<b><i>Background:</i></b> The effectiveness of prophylactic antibiotics in severe acute pancreatitis (SAP) remains a debatable issue. This meta-analysis aimed to determine the efficacy of prophylactic carbapenem antibiotics in SAP. <b><i>Methods:</i></b> This meta-analysis of prophylactic carbapenem antibiotics for SAP was conducted in PubMed, EMBASE, Web of Science, MEDLINE, and Cochrane Library up to February 2021. The related bibliographies were manually searched. The primary outcomes involved infected pancreatic or peripancreatic necrosis, mortality, complications, infections, and organ failure. <b><i>Results:</i></b> Seven articles comprised 5 randomized controlled trials and 2 retrospective observational studies, including 3,864 SAP participants. Prophylactic carbapenem antibiotics in SAP were associated with a statistically significant reduction in the incidence of infections (odds ratio [OR]: 0.27; <i>p</i> = 0.03) and complications (OR: 0.48; <i>p</i> = 0.009). Nevertheless, no statistically significant difference was demonstrated in the incidence of infected pancreatic or peripancreatic necrosis (OR: 0.74; <i>p</i> = 0.24), mortality (OR: 0.69; <i>p</i> = 0.17), extrapancreatic infection (OR: 0.64, <i>p</i> = 0.54), pulmonary infection (OR: 1.23; <i>p</i> = 0.69), blood infection (OR: 0.60; <i>p</i> = 0.35), urinary tract infection (OR: 0.97; <i>p</i> = 0.97), pancreatic pseudocyst (OR: 0.59; <i>p</i> = 0.28), fluid collection (OR: 0.91; <i>p</i> = 0.76), organ failure (OR: 0.63; <i>p</i> = 0.19), acute respiratory distress syndrome (OR: 0.80; <i>p</i> = 0.61), surgical intervention (OR: 0.97; <i>p</i> = 0.93), dialysis (OR: 2.34; <i>p</i> = 0.57), use of respirator or ventilator (OR: 1.90; <i>p</i> = 0.40), intensive care unit treatment (OR: 2.97; <i>p</i> = 0.18), and additional antibiotics (OR: 0.59; <i>p</i> = 0.28) between the experimental and control groups. <b><i>Conclusions:</i></b> It is not recommended to administer routine prophylactic carbapenem antibiotics in SAP.


Author(s):  
E. V. Potekhina ◽  
O. Yu. Vasilenko ◽  
Z. N. Golikova ◽  
M. P. Onishchenko ◽  
A. S. Noskova ◽  
...  

The aim of the study was to evaluate the informative value of various diagnostic methods for spontaneous drainage of the pancreatic pseudocyst into the stomach.Materials and methods: based on the clinical observation of a patient who received complaints of pain in the epigastrium, an episode of melena, after suffering acute pancreatitis several years ago with the development of pancreatic necrosis with an outcome in the cyst of the tail of the pancreas, drainage of the omentum bag. The patient underwent a comprehensive laboratory and instrumental examination.Results: ultrasound, endoscopic examination, MSCT suspected a malignant process in the stomach with ulceration and germination into the pancreas. After performing endoscopic ultrasonography, it was possible to differentiate the layers of the formation and make the correct diagnosis, which was confirmed by subsequent MSCT with oral contrast.Conclusions: a spontaneously opened pancreatic pseudocyst in the lumen of the stomach is a rare and difficult to diagnose disease. An integrated approach, including endoscopic, ultrasound, X-ray, and laboratory methods of investigation when compared with the clinical picture, allows us to verify the formation of the pancreas.


2021 ◽  
pp. 5-7
Author(s):  
Ganesh Chandra Karan ◽  
Kumar Akash

Background: Pancreatic pseudocysts belong to a large and hetero-geneous group of cystic pancreatic lesions and represent a complication of acute or chronic pancreatitis. This is a prospect Material and Methods: ive study conducted in the department of General surgery, at darbhanga medical college and Hospital, Darbhanga, Laheriasarai, Bihar. Study duration on One year. Conclusion: Ultrasound guided aspiration is equally safe compared to conventional surgery, It not only cures but provides palliation of symptoms and gives enough time needed for maturation of the cyst.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Carol Vitellas ◽  
Ivo Besong Mangeb ◽  
Luis Regalado ◽  
Chiemezie Chianotu Amadi

Pancreatic pseudocysts are a common complication of pancreatitis. However, mediastinal extension of a pseudocyst is rare and often presents with atypical symptoms. We present a case of mediastinal extension of a pancreatic pseudocyst in a 56-year-old woman with a history of alcohol-related chronic pancreatitis, who presented with acute on chronic epigastric abdominal pain and atypical chest pain. Serum lipase was elevated, and imaging by contrast-enhanced computed tomography (CT) demonstrated a paraesophageal fluid collection. This collection was continuous with a peripancreatic pseudocyst and extended into the posterior mediastinum via the esophageal hiatus. Mediastinal extension of a pancreatic pseudocyst was confirmed by magnetic resonance imaging (MRI). The patient was managed conservatively in the hospital with parenteral nutrition therapy, pain control, and close imaging observation. The patient was discharged home to continue conservative management and close imaging follow-up. An initial follow-up CT examination 8 weeks after discharge revealed interval decrease in the posterior mediastinal collection but also interval development of loculated left pleural and pericardial effusions.


Cureus ◽  
2021 ◽  
Author(s):  
William R Billari ◽  
Dwyer Roche ◽  
Jeremy V DiGennaro ◽  
Michael J Shallcross

2021 ◽  
Vol 8 (12) ◽  
pp. 3714
Author(s):  
Neetha V. ◽  
Anuroop Joe ◽  
Hanumanthaiah K. S. ◽  
Venkatesh S.

Mucinous cystic neoplasm of pancreas are relatively rare >95% occur in the body and tail of pancreas. Majority occur in young and middle aged female containing ovarian type subepithelial stroma. These tumors are either premalignant (MCN with low grade dysplasia) or (MCN with high grade dysplasia) or invasive carcinoma. Differential diagnosis includes pancreatic pseudocyst and pancreatic hydatid cyst. Investigations include ultrasonography (USG), Magnetic resonance imaging (MRI), Contrast enhanced computed tomography (CECT) supplemented by endoscopic USG with cyst fluid aspiration.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yulin Guo ◽  
Shun Hu ◽  
Shuo Wang ◽  
Ang Li ◽  
Feng Cao ◽  
...  

Background. Surgical interventions for pancreatic pseudocyst (PP) are traditionally managed by an open surgical approach. With the development of minimally invasive surgical techniques, a laparoscopic surgical approach for PPs has been conducted increasingly with comparable outcomes. The present study was conducted to compare the efficacy and safety of surgical intervention for PPs between the laparoscopic approach and the open approach. Methods. Databases including Cochrane Library, PubMed, and EMBASE were searched to identify studies that compared the safety and efficacy of surgical intervention for PPs between the laparoscopic approach and the open approach (until Aug 1st 2020). Results. A total of 6 studies were eligible in qualitative synthesis. The laparoscopic approach was associated with less intraoperative blood loss (MD = −69.97; 95% CI: −95.14 to −44.70, P < 0.00001 ; P = 0.86 for heterogeneity) and shorter operating time (MD = −33.12; 95% CI: −62.24 to −4.00, P = 0.03 ; P < 0.00001 for heterogeneity). There was no significant difference found between the two approaches regarding the success rate and the recurrence rate. The postoperative complications and mortality rates were comparable between the two approaches. Conclusions. The laparoscopic approach for the surgical intervention of PPs is safe and efficacious with shorter-term benefits.


2021 ◽  
Vol 88 ◽  
pp. 106546
Author(s):  
Okello Michael ◽  
Kayondo Derick ◽  
Sanjanaa Srikant ◽  
Baseka Francis Xavier ◽  
Dave Darshit

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