-
Revista Espanola de Enfermedades... Jan 2024Arterial bleeding is a dreadful late complication of acute pancreatitis that usually mandates emergent endovascular embolization or surgery. We present the case of a...
Arterial bleeding is a dreadful late complication of acute pancreatitis that usually mandates emergent endovascular embolization or surgery. We present the case of a massive arterial bleeding resulting from fistulization of a pseudocyst to the stomach, which was successfully managed by endoscopic injection of cyanoacrylate.
PubMed: 38284913
DOI: 10.17235/reed.2024.10259/2024 -
International Journal of Surgery Case... Feb 2024Chronic Pancreatitis is an irreversible inflammation of the pancreas that can lead to fibrosis and scar formation. Pseudocysts are a late complication of chronic...
INTRODUCTION AND IMPORTANCE
Chronic Pancreatitis is an irreversible inflammation of the pancreas that can lead to fibrosis and scar formation. Pseudocysts are a late complication of chronic pancreatitis and abdominal pain is the most common presenting complaint.
CASE PRESENTATION
A 48-year-old male who is a known case of chronic pancreatitis presented to our department complaining of abdominal pain for a duration of three weeks. A CT scan revealed a pseudocyst in the head of the pancreas, stones in the unicate process along with dilatation of the body and tail of the pancreas.
CLINICAL DISCUSSION
After multiple ERCP failures and considering other endoscopic options, the patient was indicated for the Whipple procedure with Roux-en-y reconstruction. Postoperatively, the patient stayed in the hospital for about a week. He was asymptomatic and well but had an elevated random blood sugar level. He was discharged and recommended to follow up with an endocrinologist.
CONCLUSION
Whipple procedure can be used for patients with multiple pancreatic duct stones when endoscopic therapies are not effective.
PubMed: 38277984
DOI: 10.1016/j.ijscr.2024.109286 -
Children (Basel, Switzerland) Jan 2024Blunt pancreatic injury (BPI) is relatively uncommon in children, and is associated with relatively high morbidity and mortality, especially if diagnosis is delayed. The... (Review)
Review
Blunt pancreatic injury (BPI) is relatively uncommon in children, and is associated with relatively high morbidity and mortality, especially if diagnosis is delayed. The aim of this report is to review the literature regarding controversial questions in the early diagnosis and management of pediatric BPI. A representative case of blunt pancreatic trauma in a six-year-old girl with delayed diagnosis and intraoperative and postoperative complications was described. A systematic search of databases and the grey literature in Scopus and Web of Science using relevant keywords was conducted. A total of 26 relevant articles published in last 5 years were found in PubMed. Although early CT performance is considered part of initial pancreatic trauma workup, the sensitivity of CT for detecting main pancreatic duct injuries in children is relatively low. MRCP and ERCP (if available) are useful for assessing ductal injury and should be performed when the status of the pancreatic duct is unclear on the CT. Most patients with low-grade pancreatic damage may be treated conservatively. Although surgery involving distal pancreatectomy remains the preferred approach for most children with high-grade pancreatic injury, there is growing evidence to suggest that non-operative management (NOM) is safe and effective. Most pancreatic pseudo cysts following NOM had relatively mild complications, and most resolved spontaneously. For those children who do require surgery, a conservative operative approach with the least risk is advocated. In conclusion, the optimal management for pediatric pancreatic trauma is controversial. Further clinical trials are required to generate clinical practice guidelines on pancreatic trauma in a child population.
PubMed: 38275445
DOI: 10.3390/children11010135 -
Cureus Jan 2024[This retracts the article DOI: 10.7759/cureus.18956.].
[This retracts the article DOI: 10.7759/cureus.18956.].
PubMed: 38274576
DOI: 10.7759/cureus.r90 -
Trauma Surgery & Acute Care Open 2024
PubMed: 38274024
DOI: 10.1136/tsaco-2023-001322 -
Frontiers in Physiology 2023Pancreatic sinistral portal hypertension (PSPH) is a common complication of acute pancreatitis (AP) and can cause massive gastrointestinal bleeding, which is one of the...
Pancreatic sinistral portal hypertension (PSPH) is a common complication of acute pancreatitis (AP) and can cause massive gastrointestinal bleeding, which is one of the causes of AP-related mortality. However, there is currently no predictive model for AP concurrent with PSPH. This study aimed to identify the risk factors for AP concurrent with PSPH and use these factors to build a related predictive model. We collected clinical data from 282 patients with AP. 192 patients were used as a training group and 90 patients as a validation group. Univariate and multivariate analyses were used to identify independent risk factors for AP complicated with PSPH, and then a nomogram was established. The models are cross verification and Internal verification. The predictive ability and accuracy of the model were evaluated based on the working curve of the subjects and the calibration curve, respectively. The clinical value of the model was evaluated using decision curve analysis (DCA). The univariate analysis revealed significant differences in the occurrence of PSPH with respect to sex, recurrent AP, history of hypertension, smoking history, patency of the splenic vein, pancreatic necrosis or pancreatic pseudocyst formation, the most significant site of pancreatic swelling, presence of a Dmure D polymer, MCTSI, and involvement of lipase and amylase. The logistic multivariate regression analysis showed that male sex, splenic-vein stenosis or occlusion and swelling were located in the body-tail, and MCTSI was an independent risk factor for PSPH. The nomogram and ROC curve were constructed. The area under the working curve of the subjects was 0.91, and the sensitivity and specificity were 82.5% and 89.1%, respectively. In the validation group, the C-index is 0.826. The nomogram was internally validated using 1,000 bootstrap samples, and the c-index was 0.898. The calibration curve demonstrated that the predicted probability was concordant with the observed probability, and the DCA confirmed that the model had robust clinical utility. Male sex, splenic-vein stenosis or occlusion, recurrent AP, and swelling are located in the body-tail, and MCTSI is an independent risk factor for the occurrence of PSPH. The predictive model developed for AP complicated with PSPH may serve toward developing preventive and therapeutic approaches for PSPH.
PubMed: 38260093
DOI: 10.3389/fphys.2023.1256615 -
Polish Archives of Internal Medicine Jan 2024
Topics: Humans; Adrenalectomy; Cysts; Hemorrhage
PubMed: 38258670
DOI: 10.20452/pamw.16669 -
Journal of Clinical Medicine Jan 2024Well-defined, faintly radiopaque lesions are occasionally observed in the antrum of the maxillary sinus in asymptomatic patients during maxillary sinus floor elevation.... (Review)
Review
Well-defined, faintly radiopaque lesions are occasionally observed in the antrum of the maxillary sinus in asymptomatic patients during maxillary sinus floor elevation. These lesions are treated as antral pseudocysts (AP) based on the clinical diagnosis in some cases, and maxillary sinus floor elevation is performed without enucleating these lesions. However, further surgery is required after implant placement if the lesion is a mucocele, odontogenic cyst, or tumour. This comprehensive clinical review aimed to identify an appropriate approach for maxillary sinus floor elevation in patients with well-defined, faintly radiopaque lesions in the antrum based on our clinical experience.
PubMed: 38256466
DOI: 10.3390/jcm13020332 -
Life (Basel, Switzerland) Jan 2024Splenic cysts are rare benign lesions of the spleen, often asymptomatic and incidentally discovered during imaging studies. While many splenic cysts remain asymptomatic...
Splenic cysts are rare benign lesions of the spleen, often asymptomatic and incidentally discovered during imaging studies. While many splenic cysts remain asymptomatic and do not require intervention, surgical management becomes essential in cases of symptomatic cysts, large cysts, or when malignancy cannot be ruled out. Laparoscopic surgery has emerged as a minimally invasive and effective approach for treating splenic cysts, offering advantages such as shorter hospital stays, reduced postoperative pain, and faster recovery. In this case report, we describe our experience with laparoscopic surgery for a symptomatic splenic cyst in a young patient.
PubMed: 38255735
DOI: 10.3390/life14010120 -
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