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The Journal of International Medical... May 2021Autoimmune pancreatitis (AIP) is a unique form of pancreatitis often associated with infiltration of immunoglobulin G4-positive cells, a swollen pancreas, and diffuse...
Autoimmune pancreatitis (AIP) is a unique form of pancreatitis often associated with infiltration of immunoglobulin G4-positive cells, a swollen pancreas, and diffuse narrowing of the pancreatic ducts. Unlike acute pancreatitis, AIP is rarely complicated with pseudocysts. Pancreatic calculi, a feature of ordinary chronic pancreatitis, are unusual during short-term follow-up in patients with AIP. We herein describe a 46-year-old man who initially presented with a submucosal tumor of the stomach. The patient was finally diagnosed with AIP accompanied by a pancreatic tail pseudocyst located in the gastric wall and pancreatic calculi by endoscopic ultrasonography-guided fine-needle aspiration. He underwent endoscopic retrograde cholangiopancreatography, pancreatic duct stent placement, and steroid treatment and achieved good clinical and laboratory responses. Although AIP is a common autoimmune disease that responds well to steroids, pseudocysts and pancreatic calculi are rare manifestations of AIP and should be given special attention, especially in patients with disease relapse.
Topics: Acute Disease; Autoimmune Pancreatitis; Calculi; Cholangiopancreatography, Endoscopic Retrograde; Humans; Male; Middle Aged; Pancreatitis
PubMed: 34034562
DOI: 10.1177/03000605211014798 -
Cureus Feb 2023Pancreatic pseudocyst is a common complication of pancreatitis and is usually located in the peripancreatic space, spleen, and retroperitoneum. An infected intrahepatic...
Pancreatic pseudocyst is a common complication of pancreatitis and is usually located in the peripancreatic space, spleen, and retroperitoneum. An infected intrahepatic pseudocyst following acute on chronic pancreatitis is extremely rare. Here, we report a case of intrahepatic pancreatic pseudocyst with superimposed infection following chronic pancreatitis in a 42-year-old female who presented with severe abdominal pain, vomiting, and bloating sensation. Her labs showed elevated pancreatic enzymes (amylase and lipase), and a provisional diagnosis of acute pancreatitis was made. Imaging revealed a cystic lesion in the left lobe and a calcified pancreas. Endoscopic aspiration of the cystic lesion and pathologic examination confirmed infected intrahepatic pancreatic pseudocyst due to the high serum amylase level and positive on culture in aspirated cystic fluid, complicated by chronic pancreatitis.
PubMed: 36994245
DOI: 10.7759/cureus.35384 -
International Journal of Surgery Case... 2018Pseudoaneurysms of the gastroduodenal artery (GDA) are rare and mostly associated with pancreatitis. However, they can occur as a possible complication following gastric...
BACKGROUND AND AIM
Pseudoaneurysms of the gastroduodenal artery (GDA) are rare and mostly associated with pancreatitis. However, they can occur as a possible complication following gastric or pancreatic surgery and thus prior recognition and prompt treatment is mandatory (Lee et al., 2009 [1]). We report a case of a ruptured GDA aneurysm in a patient who underwent roux-en-y-cystojejunostomy for traumatic pancreatic pseudocyst and this has rarely been reported in the literature. Our patient presented with melena one month post operatively. CT Angiogram showed pseudoaneurysm of the GDA and the origin of right gastroepiploic artery which was embolised. Our case highlights that GDA aneurysm must be considered in the differential for a patient who presents with melena following drainage of traumatic pancreatic pseudocyst and that it can be managed successfully with angioembolization.
CASE PRESENTATION
A young boy was operated for traumatic pancreatic pseudocyst. One month later, he presented with the complaints of melena. Patient was resuscitated initially and then CT Angiogram was planned that showed pseudo aneurysm of the GDA and the origin of right gastroepiploic artery. The aneurysm was embolised and patient was sent home later on. On two months follow up the patient was doing well and had no episode of melena.
CONCLUSION
GDA aneurysm are rare and should be suspected in a patient with GI hemorrhage after surgery for traumatic pancreatic pseudocyst. The investigation of choice is CT Angiography and endovascular angioembolization is the treatment modality of choice.
PubMed: 29227856
DOI: 10.1016/j.ijscr.2017.11.049 -
Turk Patoloji Dergisi 2015Bone cysts are benign lesions occurring in any bone, regardless of age. They are often asymptomatic but may cause pain, swelling, fractures, and local recurrence and may... (Comparative Study)
Comparative Study
OBJECTIVE
Bone cysts are benign lesions occurring in any bone, regardless of age. They are often asymptomatic but may cause pain, swelling, fractures, and local recurrence and may be confused with other bone lesions.
MATERIAL AND METHOD
We retrospectively re-evaluated 143 patients diagnosed with aneurysmal bone cyst (n=98, 68.5%), solitary bone cysts (n=17 11.9%), pseudocyst (n=10.7%), intraosseous ganglion (n=3, 2.1%), hydatid cyst (n=2; 1.4), epidermoid cyst (n=1, 0.7%) and cysts demonstrating "mixed" aneurysmal-solitary bone cyst histology (n=12, 8.4%), and compared them with nonparametric tests.
RESULTS
Aneurysmal bone cyst, solitary bone cysts and mixed cysts were frequently seen in the first two decades of life while the others occurred after the fourth decade. Aneurysmal bone cysts, intraosseous ganglion and pseudocysts were more common in women contrary to solitary bone cyst and mixed cysts (the female/male ratio was 1.22, 2 and 1.5 versus 0.7 and 0.5, respectively). Aneurysmal bone cyst, solitary bone cysts and "mixed" cysts were mostly seen in long bones, predominantly the femur, while epidermoid, hydatid and pseudocysts were all seen in flat bones like the vertebra, pelvis and mandible (p=0.001, chi-square). Repeat biopsies were performed in 19 cases (13.3%), 84.2% of which were aneurysmal bone cyst (5 conventional, 9 solid, 1 secondary and 1 subperiosteal) and three (15.8%) were mixed cysts (p=0.02, chi-square). Notably, some of them were located in inaccessible areas of pelvis (n=3), femur (n=3) and maxilla (n=2).
CONCLUSION
The most common and challenging intraosseous cysts are aneurysmal bone cysts, particularly the "solid" variant. The "mixed" aneurysmal-solitary bone cyst "subgroup" requires further research with larger series to be defined more thoroughly.
Topics: Adolescent; Adult; Age Factors; Aged; Biopsy; Bone Cysts; Bone Cysts, Aneurysmal; Child; Child, Preschool; Echinococcosis; Epidermal Cyst; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Predictive Value of Tests; Prognosis; Retrospective Studies; Sex Factors; Young Adult
PubMed: 25652560
DOI: 10.5146/tjpath.2014.01293 -
Polski Przeglad Chirurgiczny Aug 2017We report a rare case of a large mediastinal pancreatic pseudocyst compressing the left atrium and the esophagus and causing dyspnea, palpitations, and emesis. Chest...
We report a rare case of a large mediastinal pancreatic pseudocyst compressing the left atrium and the esophagus and causing dyspnea, palpitations, and emesis. Chest radiograph was non-diagnostic, esophagogastroduodenoscopy showed diffuse extrinsic compression of the distal esophagus and gastric corpus, but a definitive diagnosis was confirmed by computed tomography. We decided to perform surgery due to the recurrence of the pancreatic pseudocyst, a history of unsuccessful radiologically guided external drainage a few years earlier, and a very large diameter of the pseudocyst causing acute cardio-pulmonary distress syndrome.
Topics: Adult; Female; Humans; Mediastinal Cyst; Pancreatic Pseudocyst; Tomography, X-Ray Computed
PubMed: 28905804
DOI: 10.5604/01.3001.0010.3911 -
Acta Medica (Hradec Kralove) 2021Peritoneal pseudocysts (PPs) in patients who are diagnosed with Crohn's disease (CD), is a rarely diagnosed entity with unknown epidemiology, etiology and pathogenesis.... (Review)
Review
Peritoneal pseudocysts (PPs) in patients who are diagnosed with Crohn's disease (CD), is a rarely diagnosed entity with unknown epidemiology, etiology and pathogenesis. We present the case of a 30-year old male with known CD who presented with an acute abdomen because of a PP. PPs are developed as a complication caused in patients, suffering from mainly thee conditions. Firstly, PPs appear in patients with continuous ambulatory peritoneal dialysis (CAPD), they are also developed in patients with peritoneal trauma and finally in CD patients. Our case belongs to these three reported cases in our literature review, since it refers to a CD patient that developed PPs. He underwent emergency laparotomy and excision of the cyst, with good postoperative results. A literature review of 22 publications show that PPs often represent a diagnostic and therapeutic problem as it has a variable presentation and there are no data on what the best treatment option is - surgical excision or aspiration.
Topics: Abdomen, Acute; Adult; Crohn Disease; Cysts; Humans; Male; Peritoneal Diseases
PubMed: 33855961
DOI: 10.14712/18059694.2021.10 -
Iranian Journal of Public Health May 2018is one of the most common protozoa diagnosed in rodents. The trichomonads are generally described as presenting only trophozoite form while pseudocyst is another...
BACKGROUND
is one of the most common protozoa diagnosed in rodents. The trichomonads are generally described as presenting only trophozoite form while pseudocyst is another morphological form of trichomonads identified among gastrointestinal and genitourinary trichomonads. We identified and described different shapes of pseudocysts and trophozoite in stool samples were collected from rodents including , and .
METHODS
In this cross-sectional study, stool samples from 204 trapped rodents were collected from Meshkin Shahr during Mar to Dec 2014. Samples were preserved in formalin 10% and PVA solution and transferred to Department of Medical Protozoology and Mycology, School of Public Health, Tehran University of Medical Sciences. Formalin-ether concentration method was used for the samples. The slides were stained with tri-chrome staining method and observed under light microscope.
RESULTS
The trophozoites were classified as based on size (18 to 24 μm), presence of three anterior flagella, recurrent flagellum, undulating membrane, and axostyle in direct examination and stained slides with trichrome staining method. Fifty-five out of 204 (27%) rodents were infected with in which 51(25%) samples pseudocysts form were observed. The spherical bodies of pseudocyst with almost 8 μm size, contained internalized flagella, an undulating membrane with recurrent flagellum, axostyle, and costa were seen. The pseudocysts were more prevalent than trophozoite form and pseudocysts were found with different shapes in this study.
CONCLUSION
pseudocysts were found in stool samples of caught rodents for the first time in northwestern Iran.
PubMed: 29922616
DOI: No ID Found -
World Journal of Gastrointestinal... Sep 2019Current therapeutic techniques for pancreatic pseudocyst include surgical management with a laparoscopic approach or an open surgical procedure, percutaneous catheter...
BACKGROUND
Current therapeutic techniques for pancreatic pseudocyst include surgical management with a laparoscopic approach or an open surgical procedure, percutaneous catheter drainage and endoscopic drainage. Yet it remains controversial whether different treatment approaches affect inpatient outcome.
AIM
To investigate inpatient outcome of different treatment approaches in treating pancreatic pseudocyst.
METHODS
Here we conducted a retrospective analysis of pancreatic pseudocyst-associated hospitalizations using the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample. International Classification of Diseases 10 clinical modification and procedure codes are used.
RESULTS
A total of 7060 patients meeting the above criteria were identified. Our study revealed laparoscopic approach associated with the lowest rate of red blood cell transfusion ( < 0.001), and it had lower short-term complications including acute renal failure ( = 0.01), urinary tract infection ( = 0.01), sepsis ( < 0.001) and acute respiratory failure ( = 0.01). Laparoscopic surgical approach associated with the shortest mean length of stay ( = 0.009), and it had the lowest total charge ( = 0.03). All three modalities have similar inpatient mortality ( = 0.28). The study also revealed that percutaneous drainage associated with more emergent admission ( < 0.001), rural hospital performs the most open surgical drainage ( < 0.001) and patients who received laparoscopic drainage are more likely to be discharged home ( < 0.001).
CONCLUSION
Laparoscopic drainage of pancreatic pseudocysts associated with the least short-term complications and had better outcomes comparing to percutaneous and open surgical drainage from 2016 National Inpatient Sample database.
PubMed: 31572562
DOI: 10.4240/wjgs.v11.i9.365 -
An asymptomatic huge primary retroperitoneal pseudocyst: a case report and review of the literature.BMC Surgery Feb 2022Retroperitoneal non-pancreatic or idiopathic pseudocysts are very rare lesions. This case report aimed to present our patient and to check all the available literature... (Review)
Review
BACKGROUND
Retroperitoneal non-pancreatic or idiopathic pseudocysts are very rare lesions. This case report aimed to present our patient and to check all the available literature on this kind of rare disease.
CASE PRESENTATION
Our patient was a 67-year-old Iranian man admitted with mild abdominal discomfort for three months. Ultrasonography and CT scan revealed a huge cystic structure within the retroperitoneal space. The lesion was excised through midline laparotomy and opening of the retro-peritoneum. The histopathology of the cyst wall revealed a benign cystic lesion with no epithelial lining. A histologic diagnosis of non-neoplastic retroperitoneal pseudocyst was made.
CONCLUSION
The primary non-pancreatic retroperitoneal pseudocysts are rare lesions and have to be distinguished from other differential diagnoses of retroperitoneal lesions, and a surgeon should be aware of the possible occurrence of these lesions with unknown origin. Surgical excision is the only way to exclude malignancy and confirm the diagnosis.
Topics: Aged; Cysts; Humans; Iran; Laparotomy; Male; Retroperitoneal Space; Ultrasonography
PubMed: 35172808
DOI: 10.1186/s12893-022-01510-5 -
International Journal of Surgery Case... Nov 2021Pseudocysts of the spleen are rare entities with cystic lesions of the spleen being uncommon in general. It is estimated that splenic cysts occur in about 0, 07% of the...
INTRODUCTION AND IMPORTANCE
Pseudocysts of the spleen are rare entities with cystic lesions of the spleen being uncommon in general. It is estimated that splenic cysts occur in about 0, 07% of the population. In general, splenic cystic lesions are discovered incidentally or by mass effect. In the literature, only a limited number of splenic cysts are reported. We report a case of splenic pseudocyst with mass effect where we used laparoscopic fenestration of the pseudocyst with omentopexy as a treatment of choice.
CASE PRESENTATION
The patient is a 62-year-old male with no previous history of trauma. He visited his GP for abdominal pain with flaring towards the left shoulder accompanied by early satiety, occasional obstipation, and breathing difficulties. He was referred to our hospital after enhanced computed tomography showed a 15 × 13 cm splenic cyst with displaced stomach and pancreatic tail medially and left kidney downward. Management options were discussed with the patient and he opted for a laparoscopic approach. In this case, we performed laparoscopic fenestration of the pseudocyst with omentopexy.
CLINICAL DISCUSSION
Until recently splenectomy was the surgical treatment of choice for all large or symptomatic cystic lesions of the spleen however with growing knowledge about the protective role of the spleen an approach with spleen protection is advocated.
CONCLUSION
There are many advantages to the laparoscopic approach of splenic cystic lesions and it may be the treatment of choice for this uncommon surgical problem.
PubMed: 34666251
DOI: 10.1016/j.ijscr.2021.106475