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Medicine Nov 2023Pancreatic pseudocyst (PPC) increases the risk of a poor prognosis in in patients with acute pancreatitis (AP). Currently, an efficient tool is not available for...
Pancreatic pseudocyst (PPC) increases the risk of a poor prognosis in in patients with acute pancreatitis (AP). Currently, an efficient tool is not available for predicting the risk of PPC in patients with AP. Therefore, this research aimed to explore the risk factors associated with PPC secondary to AP and to develop a model based on clinical information for predicting PPC secondary to AP. This study included 400 patients with acute pancreatitis and pancreatic pseudocyst secondary to acute pancreatitis admitted to the emergency department and gastroenterology department of The First Affiliated Hospital of the University of Science and Technology of China from January 2019 to June 2022. Participants were divided into no PPCs (321 cases) and PPCs (79 cases). Independent factors of PPC secondary to AP were analyzed using univariate and multivariate logistic regression. The nomogram model was constructed based on multivariate logistic regression analyses, which included all risk factors, and evaluated using R. We enrolled 400 eligible patients and allocated 280 and 120 to the training and test sets, respectively. Clinical features, including severe pancreatitis history [odds ratio (OR) = 4.757; 95% confidence interval (CI): 1.758-12.871], diabetes mellitus (OR = 6.919; 95% CI: 2.084-22.967), history of biliary surgery (OR = 9.232; 95% CI: 3.022-28.203), hemoglobin (OR = 0.974; 95% CI: 0.955-0.994), albumin (OR = 0.888; 95% CI: 0.825-0.957), and body mass index (OR = 0.851; 95% CI: 0.753-0.962), were significantly associated with the incidence of PPC after AP in the training sets. Additionally, the individualized nomogram demonstrated good discrimination in the training and validation samples with good calibration, The area under the curve and 95% CI of the nomogram were 0.883 (0.839-0.927) in the training dataset and 0.839 (0.752-0.925) in the validation set. We developed a nomogram model of PPC secondary to AP using R Studio. This model has a good predictive value for PPC in patients with AP and can help improve clinical decision-making.
Topics: Humans; Pancreatitis; Acute Disease; Pancreatic Pseudocyst; Risk Factors; Nomograms; Retrospective Studies
PubMed: 38013294
DOI: 10.1097/MD.0000000000036102 -
Polish Archives of Internal Medicine Aug 2023
Topics: Humans; Pancreatic Pseudocyst; Gastrointestinal Hemorrhage
PubMed: 37416974
DOI: 10.20452/pamw.16529 -
Children (Basel, Switzerland) Jan 2024Paediatric chronic pancreatitis (CP) is a rare and debilitating pathology that often requires invasive diagnostics and therapeutic interventions either to address a... (Review)
Review
Paediatric chronic pancreatitis (CP) is a rare and debilitating pathology that often requires invasive diagnostics and therapeutic interventions either to address a primary cause such as a pancreaticobiliary malunion or to deal with secondary complications such as chronic pain. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are two endoscopic modalities that have an established diagnostic role in paediatric CP, and their therapeutic utilisation is increasing in popularity. Surgical decompression of the obstructed and dilated pancreatic duct plays a role in alleviating pancreatic duct hypertension, a common association in CP. Surgery equally has a role in certain anatomical abnormalities of the pancreaticobiliary draining system, or occasionally in some CP complications such as drainage of a symptomatic pancreatic pseudocyst.
PubMed: 38255387
DOI: 10.3390/children11010074 -
Endoscopy Dec 2023
Topics: Humans; Pancreatic Pseudocyst; Mediastinum; Endosonography; Pancreatic Cyst
PubMed: 36400044
DOI: 10.1055/a-1966-0302 -
Cureus Nov 2023Pancreatic pseudocysts are fluid-filled collections that can arise from acute or chronic pancreatitis and may lead to a range of complications, like rupture, infection,...
Pancreatic pseudocysts are fluid-filled collections that can arise from acute or chronic pancreatitis and may lead to a range of complications, like rupture, infection, hemorrhage, etc. Morbid obesity may further complicate the diagnosis and management of such cases. The present report describes the case of a 26-year-old superobese female (BMI: 58 kg/m²) with a pancreatic pseudocyst that presented diagnostic challenges and mimicked pulmonary embolism when the pseudocyst had ruptured. The patient initially presented with persistent biliary colic due to gallstones. Despite undergoing laparoscopic cholecystectomy, she continued to experience symptoms, including nausea, bloating, and inability to tolerate food, and lab tests showed progressive elevation of serum bilirubin levels. A huge pancreatic pseudocyst was found to be obliterating the gastric cavity and compressing the common bile duct after the patient was subjected to further radiological imaging. While waiting to be transferred to a tertiary center with endoscopic retrograde cholangiopancreatography (ERCP), endoscopic stenting, and other facilities, she suddenly experienced severe symptoms, like shortness of breath, upper abdominal/chest pain, tachycardia (heart rate: 140 beats per min), dizziness, and low oxygen saturation. The likelihood of pulmonary embolism (PE) was very high in the differential diagnoses, but computer tomography pulmonary angiography (CTPA) ruled out PE. Based on imaging and clinical assessment, rupture of the pancreatic pseudocyst was diagnosed. The patient was subsequently managed in a tertiary hospital endoscopically. This case highlights the challenges of diagnosing and managing pancreatic pseudocysts in extremely obese patients. It also underscores the role of a multidisciplinary approach and vigilant clinical attention to prevent misdiagnosis and optimize outcomes.
PubMed: 38161865
DOI: 10.7759/cureus.49643 -
Clinical Case Reports Jul 2023There is a high association between umbilical cord hemangiomas or cysts with fetal mortality. However, favorable outcome is possible with proper prenatal monitoring and...
KEY CLINICAL MESSAGE
There is a high association between umbilical cord hemangiomas or cysts with fetal mortality. However, favorable outcome is possible with proper prenatal monitoring and care.
ABSTRACT
Umbilical cord hemangiomas are rare neoplasms of vascular origin, commonly found in the free section of the umbilical cord proximal to placental insertion. They are associated with an increased risk of fetal mortality. We present a rare co-occurrence of an umbilical cord hemangioma and a pseudocyst managed conservatively, with favorable fetal outcome despite the interval increase in size, decreased caliber of the umbilical arteries, and fetal chest compression.
PubMed: 37415590
DOI: 10.1002/ccr3.7656 -
Journal of Surgical Case Reports Jun 2024Pancreatic pseudocysts are surrounded by a non-epithelialized wall confined to the pancreas and localized to the pancreatic tissue or adjacent pancreatic cavity. In...
Pancreatic pseudocysts are surrounded by a non-epithelialized wall confined to the pancreas and localized to the pancreatic tissue or adjacent pancreatic cavity. In contrast, pancreatic cystic tumors occur less frequently than solid lesions and are often detected incidentally on imaging. Regarding the qualitative diagnosis of pancreatic pseudocysts, it is important to differentiate them from neoplastic cysts. We report the case of a 74-year-old woman with a giant hemorrhagic pancreatic pseudocyst and a suspected cystic pancreatic tumor, wherein distal pancreatectomy and splenectomy with lymph node dissection were performed. The patient was discharged 11 days postsurgery, with a good postoperative course. There are no reports of giant pancreatic pseudocysts larger than 10 cm with hematoma contents. The presumptive diagnosis of pseudocysts based on imaging alone may be difficult. Surgical resection is considered when it is difficult to distinguish a giant pancreatic pseudocyst from a cystic neoplasm.
PubMed: 38832062
DOI: 10.1093/jscr/rjae393 -
Scientific Reports Nov 2023Extracellular vesicles (EV) carry their cargo in a membrane protected form, however, their value in early diagnostics is not well known. Although pancreatic cysts are...
Extracellular vesicles (EV) carry their cargo in a membrane protected form, however, their value in early diagnostics is not well known. Although pancreatic cysts are heterogeneous, they can be clustered into the larger groups of pseudocysts (PC), and serous and mucinous pancreatic cystic neoplasms (S-PCN and M-PCN, respectively). In contrast to PCs and S-PCNs, M-PCNs may progress to malignant pancreatic cancers. Since current diagnostic tools do not meet the criteria of high sensitivity and specificity, novel methods are urgently needed to differentiate M-PCNs from other cysts. We show that cyst fluid is a rich source of EVs that are positive and negative for the EV markers CD63 and CD81, respectively. Whereas we found no difference in the EV number when comparing M-PCN with other pancreatic cysts, our EV-based biomarker identification showed that EVs from M-PCNs had a higher level of miR-200b. We also prove that not only EV-derived, but also total cyst fluid miR-200b discriminates patients with M-PCN from other pancreatic cysts with a higher sensitivity and specificity compared to other diagnostic methods, providing the possibility for clinical applications. Our results show that measuring miR-200b in cyst fluid-derived EVs or from cyst fluid may be clinically important in categorizing patients.
Topics: Humans; Biomarkers; MicroRNAs; Pancreas; Pancreatic Cyst; Pancreatic Neoplasms
PubMed: 37963969
DOI: 10.1038/s41598-023-47129-1 -
Oman Medical Journal Jul 2023Traumatic pulmonary pseudocyst is a rare type of parenchymal injury, estimated to occur in 0.1% of all chest traumas. We report a rare case of traumatic pulmonary...
Traumatic pulmonary pseudocyst is a rare type of parenchymal injury, estimated to occur in 0.1% of all chest traumas. We report a rare case of traumatic pulmonary pseudocyst in a seven-year-old boy who presented with a chest injury from a traffic accident. He had a scapula fracture, multiple abrasions on his body, and decreased respiratory sounds in the left hemithorax. His Glasgow Coma Scale score was 15. Chest X-ray suggested a 3 × 3.5 cm cavitary lesion. Computed tomography scan revealed a pulmonary pseudocyst in addition to parenchymal contusion and pneumothorax. A Velpeau bandage was applied to the scapula fracture. After five days of in-hospital observation without any thoracic intervention, the patient was discharged free of complications.
PubMed: 37724321
DOI: 10.5001/omj.2023.34 -
ACG Case Reports Journal Sep 2023Dengue fever can lead to a range of symptoms, including severe manifestations such as dengue hemorrhagic fever. We report a rare case of severe dengue with hemorrhagic...
Dengue fever can lead to a range of symptoms, including severe manifestations such as dengue hemorrhagic fever. We report a rare case of severe dengue with hemorrhagic pancreatitis and pseudocyst formation in a 28-year-old woman. Initially presenting with fever, abdominal pain, and gastrointestinal symptoms, the patient developed worsening pain, vomiting, and an abdominal mass. Imaging revealed a pancreatic mass, and elevated amylase and lipase confirmed pancreatitis. Interventional radiology drained the hemorrhagic fluid from the suspected pseudocyst, leading to patient improvement and eventual discharge. This uncommon complication of acute hemorrhagic pancreatitis in dengue fever has not been previously documented.
PubMed: 37753103
DOI: 10.14309/crj.0000000000001152