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Cureus Nov 2020Mediastinal pancreatic pseudocysts are rarely encountered complications of pancreatic diseases. Pseudocysts most often expand into surrounding structures, just rarely...
Mediastinal pancreatic pseudocysts are rarely encountered complications of pancreatic diseases. Pseudocysts most often expand into surrounding structures, just rarely into the mediastinum. Usually, they present with abdominal pain, and the symptoms correlate with the location of the pseudocysts. We describe a case of a pancreatic pseudocyst that penetrated the thoracic cavity through the diaphragm and set up a communication with the bronchial tree developing an episode of massive hemoptysis. This case is of particular interest because just a few similar cases were published before. Based on this report, we emphasize the need for early accurate diagnosis; surgeons should maintain a higher index of suspicion for mediastinal pancreatic pseudocyst in patients with chronic pancreatitis.
PubMed: 33354462
DOI: 10.7759/cureus.11518 -
Nihon Shokakibyo Gakkai Zasshi = the... 2016A 15-year-old boy was admitted to our hospital with a recent increase in the size of a preexisting pancreatic pseudocyst. At 11 years of age, he was diagnosed with acute... (Review)
Review
A 15-year-old boy was admitted to our hospital with a recent increase in the size of a preexisting pancreatic pseudocyst. At 11 years of age, he was diagnosed with acute lymphoid leukemia (ALL) and received chemotherapy with L-asparaginase (L-Asp); he developed the pancreatic pseudocyst following L-Asp-induced acute pancreatitis. The pancreatic pseudocyst had increased to 120mm in diameter. He developed epigastralgia and portal hypertension. Endoscopic ultrasound (EUS)-guided cystogastrostomy with the placement of a 7-cm 7-Fr plastic stent and a 5-Fr NB pigtail catheter led to the near-complete resolution of the pseudocyst. There were no signs of recurrence within the first year after intervention. EUS-guided drainage, increasingly used for pseudocysts, should be considered as an effective treatment approach for pediatric pancreatic pseudocysts.
Topics: Adolescent; Drainage; Endosonography; Gastrostomy; Humans; Male; Pancreatic Pseudocyst; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 26743556
DOI: 10.11405/nisshoshi.113.71 -
Southern Medical Journal Mar 2001Surgical drainage is the standard treatment for pancreatic pseudocysts and their complications. However, acute symptomatic pancreatic pseudocysts are amenable to... (Review)
Review
Surgical drainage is the standard treatment for pancreatic pseudocysts and their complications. However, acute symptomatic pancreatic pseudocysts are amenable to endoscopic internal drainage in select cases. We report a case of pancreatic pseudocyst with biliary fistula resulting from a recurrent pseudocyst treated with endoscopic stent drainage.
Topics: Biliary Fistula; Diagnosis, Differential; Drainage; Endoscopy; Humans; Male; Middle Aged; Pancreatic Pseudocyst; Recurrence; Stents; Tomography, X-Ray Computed
PubMed: 11284527
DOI: No ID Found -
ACG Case Reports Journal Aug 2021Pancreatic pseudocysts are often drained endoscopically after 4-6 weeks of maturation. Allowing for developed encapsulation ensures that the cyst walls are strong enough...
Pancreatic pseudocysts are often drained endoscopically after 4-6 weeks of maturation. Allowing for developed encapsulation ensures that the cyst walls are strong enough to sustain drainage. However, in 3%-5% of these cases, pseudocysts will rupture spontaneously and put patients at risk of peritonitis. We present the first documented case of pancreatic pseudocyst rupture after upper endoscopy. Exploratory laparotomy confirmed the absence of viscus perforation and highlighted the danger of any procedure that increases intra-abdominal pressure in a patient with a pancreatic pseudocyst. Awareness of this complication should impact our decision when considering endoscopy in patients with pancreatic pseudocysts.
PubMed: 34476278
DOI: 10.14309/crj.0000000000000651 -
Khirurgiia 2022To select the optimal treatment for uninfected and suppurative rare mediastinal pancreatobiliary pseudocysts.
OBJECTIVE
To select the optimal treatment for uninfected and suppurative rare mediastinal pancreatobiliary pseudocysts.
MATERIAL AND METHODS
There were 10 patients with mediastinal pancreatogenic (=9) and biliogenic (=1) pseudocysts formed through esophageal (=9) and aortic (=1) hiatus of the diaphragm. All patients were divided into groups: group A - uninfected pancreatic pseudocysts (=5) formed through esophageal hiatus; group B - 5 patients with suppurative pancreatogenic (=4) and biliogenic (=1) mediastinitis complicated by biliopleuroesophageal (=1), pancreatoesophageal (=1) and pancreatopleural (=2) fistulas.
RESULTS
In the group A, simultaneous procedures (=5) were performed depending on pancreatic parenchyma and pancreatic duct destruction. Distal ductal obstruction required Frey procedure (=3). If distal duct was patent, we resected cyst-containing pancreatic tail (=2). Early and long-term results were favorable. In the group B, mediastinitis persisted for a long time with normal temperature as a rule. In our opinion, mild course is associated with gradual introduction of purulent tissues into mediastinum and development of a tissue barrier. Two-stage surgeries were performed in patients with pancreatopleural empyema. Mediastinitis lasting 6-8 weeks caused perforation of the lower third of esophagus (=2) and death of 1 patient. Risk factors of mediastinal pseudocysts: hypertension in pancreatic duct and pseudocysts, immobile cicatricial tissues of omental bursa, proximity of subdiaphragmatic structures to esophageal and aortic hiatus of the diaphragm. Pressure in aortic canal (mmHg) is 10 times higher than in esophageal canal that increases migration through the esophageal hiatus. It is advisable to distinguish pancreatoesophageal and biliopleuroesophageal fistulas.
CONCLUSION
Uninfected mediastinal pseudocysts require simultaneous procedures, pancreatopleural empyema - two-stage interventions. Therapy is recommended in patients with esophageal fistula and no severe symptoms and intoxication.
Topics: Drainage; Humans; Mediastinum; Pancreas; Pancreatic Ducts; Pancreatic Pseudocyst
PubMed: 35289550
DOI: 10.17116/hirurgia202203156 -
Cancer Apr 2009Currently, the preoperative diagnosis of a pancreatic cyst is based on clinical and imaging findings, frequently in conjunction with chemical analysis of cyst fluid and...
BACKGROUND
Currently, the preoperative diagnosis of a pancreatic cyst is based on clinical and imaging findings, frequently in conjunction with chemical analysis of cyst fluid and cytologic evaluation. The purpose of these diagnostic tests is to distinguish benign from malignant cysts of the pancreas. Accordingly, it is imperative to distinguish pancreatic pseudocysts from their mimics. In this study, the authors explored the cytomorphologic features of pseudocyst of the pancreas and evaluated the role of Alcian blue and mucicarmine stains in the cytologic evaluation of pancreatic cysts.
METHODS
Forty-two patients were identified who had an eventual diagnosis of pancreatic pseudocyst and had an endoscopic ultrasound-guided fine-needle aspirate available. Clinical and imaging findings and chemical analyses of cyst fluid were recorded. The cytologic preparations were evaluated for gastrointestinal contamination, inflammatory cells, mucin, and pigmented material. The cytomorphologic features of 110 neoplastic mucinous cysts (intraductal papillary-mucinous neoplasms/mucinous cystic neoplasms of the pancreas) were evaluated and compared with the pseudocysts.
RESULTS
The majority of patients (95%) had a prior episode of pancreatitis. On imaging, the pseudocysts were unilocular (92%). In 69% of cases, the endosonographic diagnosis was that of a pseudocyst. The mean carcinoembryonic antigen level was 41 ng/mL. In contrast, the cytopathologist rendered a definitive diagnosis of pseudocyst in only 10% of cases. The majority of smears (75%) revealed neutrophils and/or histiocytes. Atypical epithelial clusters were identified in 3 cases, 1 of which was diagnosed as suspicious for carcinoma. Yellow pigmented material, which was identified in 13 pseudocysts (31%), was not observed in neoplastic mucinous cysts. Alcian blue- and mucicarmine-positive material was identified in 64% and 40% of pseudocysts, respectively, and in 57% and 38% of neoplastic mucinous cysts, respectively.
CONCLUSIONS
The diagnosis of a pseudocyst depended primarily on clinical and imaging findings and on chemical analysis of cyst fluid. The cytologic features frequently were nonspecific. The presence of yellow pigmented material served as a surrogate marker of a pseudocyst. Special stains for mucin did not distinguish pseudocysts from neoplastic mucinous cysts.
Topics: Adult; Alcian Blue; Carcinoembryonic Antigen; Carmine; Cyst Fluid; Cytodiagnosis; Diagnosis, Differential; Endosonography; Epithelial Cells; Female; Histiocytes; Humans; Male; Middle Aged; Mucins; Neutrophils; Pancreas; Pancreatic Neoplasms; Pancreatic Pseudocyst; Reproducibility of Results; Sensitivity and Specificity; Staining and Labeling
PubMed: 19365837
DOI: 10.1002/cncy.20000 -
Annales de Dermatologie Et de... 2014Pseudocysts of the scalp are a poorly known entity. Herein we present two new cases.
BACKGROUND
Pseudocysts of the scalp are a poorly known entity. Herein we present two new cases.
CASE REPORT
Two male patients aged respectively 42 and 33 years had been presenting a small number of pseudocystic lesions on the scalp, as well as alopecia limited to the same region, for a number of years. Inflammatory episodes had occurred in certain lesions. In one case, biopsy showed an aspect typical of pseudocyst of the scalp and the lesions appeared to stabilize on treatment with doxycycline.
DISCUSSION
Pseudocysts of the scalp are also known as aseptic nodules of the scalp, a term that appears to us to be less appropriate. They form lesions involving alopecia and they may be inflammatory to various degrees. Following incision of these lesions, a deep yellow fluid liquid is released that may be shown by microbiological analysis to be sterile. Histological analysis reveals a pseudocystic wall associated with perilesional inflammatory remodelling. The cysts are frequently confused with dissecting cellulitis of the scalp, but the prognosis is more encouraging. Treatment involves surgical excision, and intralesional injections of corticosteroids or doxycycline.
Topics: Adult; Alopecia; Anti-Bacterial Agents; Cyst Fluid; Cysts; Diagnosis, Differential; Doxycycline; Folliculitis; Granuloma, Giant Cell; Humans; Male; Scalp Dermatoses
PubMed: 24951142
DOI: 10.1016/j.annder.2014.03.004 -
Parasitology Research Jul 2012Trichomonas vaginalis, a flagellated protozoan parasite causes a variety of adverse health consequences in both men and women. The parasite exists in the trophozoite and...
Trichomonas vaginalis, a flagellated protozoan parasite causes a variety of adverse health consequences in both men and women. The parasite exists in the trophozoite and the pseudocystic stage. The study reports for the first time that pseudocyst forms of T. vaginalis isolated from cervical neoplasia (CN) patients demonstrated distinct, different and significant in vitro growth profiles when grown in vitro cultures from day 1 up to day 5 (p<0.05, Mann-Whitney test) when compared with the same life cycle stages isolated from non-cervical neoplasia but symptomatic patients (NCN). Pseudocysts from CN and NCN isolates remained viable in distilled water until 3 h 10 min and 2 h 10 min, respectively. The nucleus of pseudocysts in CN isolates using acridine orange and DAPI showed more intense staining revealing higher nuclear content. The FITC-labeled Concanavalin A stained stronger green fluorescence with surface of pseudocysts in CN isolates showing more rough and creased surface with higher numbers of deep micropores with larger numbers of chromatin masses, vacuoles, and hydrogenosomes. The study confirms that pseudocystic stage from CN, despite the uniformity in appearance of being rounded and showing no motility without a true cyst wall under light microscopy, demonstrated different biochemical, surface, and ultrastructural properties. The study provides evidence that phenotypic variant forms of pseudocysts does exist and possibly does play a role in exacerbating cervical cancer.
Topics: Cell Survival; Concanavalin A; Female; Humans; Staining and Labeling; Trichomonas Infections; Trichomonas vaginalis; Uterine Cervical Neoplasms
PubMed: 22398830
DOI: 10.1007/s00436-012-2848-3 -
Langenbecks Archiv Fur Chirurgie.... 1996A total of 29 children and adolescents underwent surgery for cystic (n = 2) or pseudocystic (n = 23) lesions or papillary-cystic neoplasms (n = 2) of the pancreas. The... (Review)
Review
A total of 29 children and adolescents underwent surgery for cystic (n = 2) or pseudocystic (n = 23) lesions or papillary-cystic neoplasms (n = 2) of the pancreas. The special conditions of paediatric patients (differential diagnosis, management and prognosis of posttraumatic, postnecrotic, inflammatory and malignant diseases) are discussed in the present literature.
Topics: Abdominal Injuries; Adolescent; Child; Child, Preschool; Cystadenocarcinoma, Papillary; Diagnosis, Differential; Female; Humans; Male; Necrosis; Pancreas; Pancreatic Cyst; Pancreatic Neoplasms; Pancreatic Pseudocyst; Prognosis; Wounds, Nonpenetrating
PubMed: 9101775
DOI: No ID Found -
Digestive Diseases and Sciences Dec 1981Pancreatic pseudocysts are encapsulated collections of fluid which may complicate trauma or inflammation of the pancreas. The correct preoperative diagnosis of the...
Pancreatic pseudocysts are encapsulated collections of fluid which may complicate trauma or inflammation of the pancreas. The correct preoperative diagnosis of the pseudocyst can be established easily by the modern techniques of ultrasonography or computed tomography (1-3). However, recognition of the lesion on plain radiographs of the abdomen is rarely possible because the wall and content of pancreatic pseudocysts do not show a visually perceptible difference in density from the adjacent soft tissues (4). This report concerns an exceptional instance whereby a pancreatic pseudocyst was clearly demarcated by virtue of radiographically detectable calcium deposits in its wall.
Topics: Calcinosis; Humans; Male; Middle Aged; Pancreatic Cyst; Pancreatic Pseudocyst; Radiography; Radionuclide Imaging
PubMed: 7307863
DOI: 10.1007/BF01295982