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Saudi Journal of Gastroenterology :... 2019Pancreatic fluid collections (PFCs) develop as a result of damage to the major or peripheral pancreatic ducts, complication due to acute or chronic pancreatitis, trauma... (Review)
Review
Pancreatic fluid collections (PFCs) develop as a result of damage to the major or peripheral pancreatic ducts, complication due to acute or chronic pancreatitis, trauma or iatrogenic causes. PFCs include pancreatic pseudocysts (PPs) and walled-off necrosis (WON). PFCs usually resolve spontaneously and are asymptomatic, but if they persist, increase in dimension or became symptomatics, therapeutic intervention is required. Available therapeutic interventions include surgical, percutaneous, and endoscopic drainage. The endoscopic approach is nowadays considered the first line-treatment of PFCs due to various advantages when compared with surgical or percutaneous drainage: decreased morbidity, length of hospital stay, and reduced costs. In the last few years, the endoscopic ultrasound (EUS)-guided transmural drainage, initially with plastic stents, gained popularity. More recently, fully covered self-expanding lumen-apposing metal stents (LAMS) have been demonstrated to be both, safe and effective with high clinical and technical success, reducing the risk of perforation, peritoneal leakage, migration and facilitating the drainage of necrotic contents. In the last few years, several studies evaluating the safety and efficacy of LAMS and their differences with plastic stents have been performed, but literature on the removal timing of this device and associated complications is still limited. The aim of this review is to analyze studies reporting information about the retrieval timing of LAMS and the related adverse events.
Topics: Body Fluids; Device Removal; Drainage; Endoscopy; Endosonography; Female; Humans; Male; Metals; Necrosis; Outcome Assessment, Health Care; Pancreatic Juice; Pancreatic Pseudocyst; Pancreatitis; Stents; Treatment Outcome
PubMed: 31823862
DOI: 10.4103/sjg.SJG_166_19 -
Diagnostics (Basel, Switzerland) Dec 2022We aimed at evaluating the prognostic capacity of the inflammatory indices derived from routine complete blood cell counts in two groups of patients with acute...
Has COVID-19 Modified the Weight of Known Systemic Inflammation Indexes and the New Ones (MCVL and IIC) in the Assessment as Predictive Factors of Complications and Mortality in Acute Pancreatitis?
We aimed at evaluating the prognostic capacity of the inflammatory indices derived from routine complete blood cell counts in two groups of patients with acute pancreatitis from two different time periods, before and during the COVID-19 pandemic, when a high incidence of complications with surgical risk and mortality was found. Two new markers were introduced: the mean corpuscular volume to lymphocyte ratio (MCVL) and the cumulative inflammatory index (IIC), which were calculated at a baseline in the two groups of patients. Of the already established markers, none of them managed to effectively predict the complications with surgical risk and mortality, with a decrease of less than 50% in specificity in the peri-COVID group. The MCVL had the best prediction of complications with surgical risk in both the pre-COVID and peri-COVID groups, validated it as an independent factor by multivariate analysis. The IIC had the best prediction of mortality in both periods and was proven to be an independent factor by multivariate analysis. As the IIC predicted death best, we tested the occurrence of death and found that patients with PA who had an IIC > 12.12 presented a risk of death 4.08 times higher in the pre-COVID group and 3.33 times higher in the peri-COVID group. The new MCVL and IIC independent markers had a superior sensitivity and specificity in predicting surgical risk complications and, respectively, mortality in the group of patients with acute pancreatitis during the COVID-19 pandemic, which makes them widely applicable in populations with modified immune and inflammatory status. Conclusions: In patients with acute pancreatitis, MCVL has a significant predictive value regarding complications with surgical risk (abscess, necrosis, and pseudocyst), and the IIC has a significant predictive value for mortality.
PubMed: 36553125
DOI: 10.3390/diagnostics12123118 -
European Journal of Case Reports in... 2020Acute pancreatitis (AP) remains one of the most common causes of emergency department visits in the USA. The literature supports an association between...
UNLABELLED
Acute pancreatitis (AP) remains one of the most common causes of emergency department visits in the USA. The literature supports an association between angiotensin-converting enzyme inhibitors (ACEi), mainly at steady-state doses, and AP. We present a case of recurrent AP and pseudocyst formation following multiple ACEi dose adjustments after a steady-state period lasting for over a decade. Previous reports have rarely described ACEi-induced pancreatitis and pseudocyst development. ACEi can cause significant ductal obstruction and fluid retention due to its angioedema effects. Consequently, it may trigger AP complicated by pseudocyst formation. Therefore, ACEi administration must be considered in the appropriate clinical context.
LEARNING POINTS
Although rare, ACEi is an emerging cause of drug-induced pancreatitis and often goes unrecognized.Multiple dose changes within a short period of time can lead to acute drug-induced pancreatitis (DIP), in addition to classic DIP caused by steady-state doses.ACEi-induced angioedema damages the ductal architecture and also has longer-lasting effects such as pseudocyst formation.
PubMed: 33457354
DOI: 10.12890/2020_001956 -
Cancers Jun 2023A wide variety of renal neoplasms can have cystic areas. These can occur for different reasons: some tumors have an intrinsic cystic architecture, while others exhibit... (Review)
Review
A wide variety of renal neoplasms can have cystic areas. These can occur for different reasons: some tumors have an intrinsic cystic architecture, while others exhibit pseudocystic degeneration of necrotic foci or they have cystically dilated renal tubules constrained by stromal neoplastic cells. Clear cell renal cell carcinoma (CCRCC), either solid or cystic, is the most frequent type of renal cancer. While pseudocysts are found in high-grade aggressive CCRCC, cystic growth is associated with low-grade indolent cases. The latter also form through a cyst-dependent molecular pathway, and they are more frequent in patients suffering from VHL disease. The differential diagnosis of multilocular cystic renal neoplasm of low malignant potential and clear cell papillary renal cell tumor can be especially hard and requires a focused macroscopical and microscopical pathological analysis. As every class of renal tumor includes cystic forms, knowledge of the criteria required for a differential diagnosis is mandatory.
PubMed: 37444462
DOI: 10.3390/cancers15133352 -
Cureus Apr 2021Cystic lesions of the spleen are rare lesions and can be parasitic or nonparasitic. Nonparasitic cysts are of two types: primary cysts and secondary pseudocysts....
Cystic lesions of the spleen are rare lesions and can be parasitic or nonparasitic. Nonparasitic cysts are of two types: primary cysts and secondary pseudocysts. Primary cysts of the spleen are very rare and are also called true, congenital, epidermoid, or epithelial cysts. Splenic cysts are usually asymptomatic and often found incidentally during imaging studies. We are presenting a case of a 19-year-old female with a large splenic cyst which was surgically treated by open splenectomy.
PubMed: 33859922
DOI: 10.7759/cureus.14435 -
Gastroenterology Research and Practice 2022To compare the conventional treatment and continuous veno-venous haemofiltration (CVVH) in severe acute pancreatitis (SAP) for the prevention of pseudocyst and...
OBJECTIVE
To compare the conventional treatment and continuous veno-venous haemofiltration (CVVH) in severe acute pancreatitis (SAP) for the prevention of pseudocyst and walled-off necrosis. . Forty-two patients were divided into two treatment groups: conventional treatment group contained 24 patients and CVVH had 18. Conventional treatment group patients were treated symptomatically and according to the causes. CVVH group patients were treated symptomatically, and CVVH was done within 2 hours of admission.
RESULTS
In both groups, there was a decrease in amylase, lipase, CRP, IL-6, IL-10, TNF-alpha, Ranson score, Balthazar score, and APACHE-II score after 72 hours, but the decrease was significantly greater in CVVH patients. There were no any local pancreatic complications in CVVH patients, but 1 patient had an acute peripancreatic fluid collection, 2 patients had pseudocyst, and 2 patients had walled-off necrosis (WON), and a mortality one was seen in the conventional treatment group.
CONCLUSION
The present study shows that early CVVH may be able to prevent the formation of pseudocyst and win in SAP patients.
PubMed: 35296066
DOI: 10.1155/2022/7575231 -
Cureus Sep 2022Pancreatic cysts are usually asymptomatic over 70% of the time. They can be benign or malignant. Enhanced imaging modalities and increased usage of routine imaging have...
Pancreatic cysts are usually asymptomatic over 70% of the time. They can be benign or malignant. Enhanced imaging modalities and increased usage of routine imaging have increased the identification of pancreatic cysts. If symptomatic, abdominal pain or back pain, unexplained weight loss, jaundice, steatorrhea or palpable mass are usually the presenting complaints. Pancreatic cysts are typically assessed by cross-sectional computed tomography (CT) and magnetic resonance imaging (MRI). In this article, we present a case of a 33-year-old female with a recurrent large pancreatic pseudocyst, initially measured 15.8 cm x 14 cm x 14 cm, who was subsequently admitted to our unit and managed successfully. After undergoing diagnostic laparoscopy, exploratory laparotomy, and pancreatic cystogastrostomy, the pseudocyst shrunk to 8 cm x 6 cm over 13 weeks. It is rare to come across a pseudocyst of such large dimensions. Despite its large size, the patient presented with vague abdominal pain as the only chief complaint. The unusual presentation of symptoms and the enormous size of the pseudocyst make this a unique case. Managing giant pancreatic pseudocysts can be complex, as seen in this scenario by the multiple approaches attempted to treat the pseudocyst.
PubMed: 36299965
DOI: 10.7759/cureus.29456 -
Radiologia 2023Palpable tumors in children are a common reason for consulting a radiologist. The origin of these lesions varies widely, and although they are common, classic radiology...
Palpable tumors in children are a common reason for consulting a radiologist. The origin of these lesions varies widely, and although they are common, classic radiology books do not cover some of them. This series of two articles aims to review the clinical and radiological characteristics of a selection of palpable tumors in children that radiologists need to be familiar with.
Topics: Humans; Child; Fibroma; Soft Tissue Neoplasms; Diagnostic Imaging
PubMed: 36842785
DOI: 10.1016/j.rxeng.2023.01.001 -
Revista Espanola de Enfermedades... Aug 2023Pancreatic pseudocysts are mostly located in the peripancreatic region, but extra-abdominal intrathoracic extensions can occur and mimic respiratory and ischemic...
Pancreatic pseudocysts are mostly located in the peripancreatic region, but extra-abdominal intrathoracic extensions can occur and mimic respiratory and ischemic symptoms. Mediastinal location is an example that can present with dyspnea and retrosternal chest pain. Pancreatic-pleural fistulas can form from pseudocysts, often resulting in large and recurrent pleural effusions. In the described case, a 50-year-old man with a previous subdiaphragmatic pseudocyst presented an acute episode of respiratory symptoms and was diagnosed with a newly organized collection located intrathoracically adjacent to the previous one, formed by the fistulization of the abdominal pseudocyst. No similar cases have been described or published in indexed PubMed databases until the year 2023.
PubMed: 37539529
DOI: 10.17235/reed.2023.9819/2023 -
Clinical Case Reports May 2022We present a case report of a 2-year-old boy who presented to a local hospital to evaluate vague abdominal symptoms of one-month duration. The patient, therefore, had an...
We present a case report of a 2-year-old boy who presented to a local hospital to evaluate vague abdominal symptoms of one-month duration. The patient, therefore, had an open cystogastrostomy and drainage of the free abdominal fluid with minimal complications. He was monitored for several days after his surgery.
PubMed: 35600019
DOI: 10.1002/ccr3.5879