Gastric Perforation Associated With Acute Pancreatitis: Case Report

Losada, Héctor; López, Mario Gonzalo Cantín; Avaria, Pablo; Troncoso, A.

doi:10.1590/0102-6720201700020019

Cited by 4 publications

(5 citation statements)

References 10 publications

(14 reference statements)

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“…Má absorção de lipídios ocorre mais precocemente do que a de outros nutrientes (proteínas e carboidratos), já que a secreção de lipase diminui mais rapidamente do que a secreção de protease e amilase (FAGUNDES; GRADELHA, 2014) e (LEAL e ALMEIDA, 2019) e (LOSADA et. al, 2017).…”

Section: Resultsunclassified

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Pancreatite: uma revisão literária do disponível acerca de sua incidência, etiologia, manifestação clínica, diagnóstico, tratamento da patologia ou suas formas de apresentação

Colognesi¹,

Spaziani²,

Freitas³

et al. 2020

BJHR

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RESUMO A pancreatite aguda é uma doença que tem como substrato um processo inflamatório da glândula pancreática, decorrente da ação de enzimas inadequadamente ativadas. Considerando a importância do tema, esse estudo visa revisar o disponível na literatura acerca dessa patologia. A metodologia aplicada nesse trabalho foi a pesquisa bibliográfica. Foram selecionados 10 artigos. O tratamento inicial da pancreatite aguda é clínico, devendo ser realizado em unidades de terapia intensiva, na dependência de sua gravidade. As medidas iniciais são jejum oral, hidratação parenteral, nutrição parenteral e analgesia sistêmica. Ainda hoje discute-se o valor da utilização rotineira de sonda nasogástrica, bloqueadores da secreção gástrica, bloqueadores da secreção pancreática, análogos da somatostatina e antibióticos.

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Section: Resultsunclassified

“…Por outro lado, na ausência de quadro agudo, podem ser encontrados níveis séricos de lipase e/ou amilase reduzidos. Porém, a sensibilidade destes testes é baixa, e nenhum deles, isoladamente, são úteis para se estabelcer o diagnóstico definitivo (SEPULVEDA e GUERRERO-LOZANO, 2019) e (LOSADA et. al, 2017).…”

Section: Resultsunclassified

Pancreatite: uma revisão literária do disponível acerca de sua incidência, etiologia, manifestação clínica, diagnóstico, tratamento da patologia ou suas formas de apresentação

Colognesi¹,

Spaziani²,

Freitas³

et al. 2020

BJHR

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“…Enteric perforations are a rare complication of necrotizing pancreatitis and have been described in only a few case reports. Reference [4] reported necrotizing pancreatitis leading to gastric perforation. Reference [5] described a patient with acute pancreatitis and gastric perforation, which was caused by gastric erosion and rupture of a pseudoaneurysm.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Perforated Gastric Remnant after Roux-enY Gastric Bypass

Ahmed

Koilpillai²,

Khan³

et al. 2023

CLINICMED

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Morbid obesity is a major health problem worldwide and the Roux-en-Y gastric bypass (RYGB) is a popular surgical treatment. A 40 year old woman, 17 years post RYGB presented with concurrent symptomatic gastric ulcers and acute pancreatitis. The diagnosis was difficult and after failed medical therapy, surgery was required. The gastric remnant is not easily accessible by endoscopy thus; detecting PUD in this excluded segment is difficult. As a result, alternative methods, such as exploratory laparotomy or pediatric endoscopy may be required to effectively diagnose the gastric remnant.

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“…The extent of the disease also has significant implications, both for the stratification of cancer risk and for making the right decision on surgical resection margins 15 , in order to prevent relapse 3 , 35 . In addition, new evidence suggests that mixed-type multifocality is associated with malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…The increased use of computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography (EUS) has increased the recognition of pancreatic cystic lesions, classified as neoplastic and pseudocyst 6 , 8 , 21 , 28 . The most common cystic neoplasms are: serous cystic neoplasia, mucinous, solid-cystic pseudopapillary (Frantz) and papilliferous mucinous mucinous intraductal neoplasia (NIMP) 2 , 15 , 31 . The diagnosis and treatment of the latter has evolved since its first description by Ohashi et al 20 .…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Cholangiopancreatography (Mrcp) Versus Endosonography-Guided Fine Needle Aspiration (Eus-Fna) for Diagnosis and Follow-Up of Pancreatic Intraductal Papillary Mucinous Neoplasms

Costa

Guerra

Goldman

et al. 2019

ABCD, arq. bras. cir. dig.

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Background:Intraductal papillary mucinous tumor (IPMN) are being diagnosed with increasing frequency. Computerized tomography scanning is commonly used as the primary imaging modality before surgery nonetheless magnetic resonance cholangiopancreatography (MRCP) provides better characterization. Endosonography-guided fine needle aspiration (EUS-FNA) has emerged as a way to reach pathological diagnose. Aim:To compare results of both methods with surgical pathology findings for classification of IPMN. Methods:Thirty-six patients submitted to surgical resection with preoperative suspect of IPMN were submitted preoperatively to MRCP and EUS-FNA. Images obtained were analyzed according to a classification determined for each method. ROC curve was used for statistical analysis, that compared the images tests with the purpose of finding the best method for diagnosis and classification of IPMN. Results:Sixteen patients underwent pancreatoduodenectomy, 16 to subtotal pancreatectomy and only four laparotomy. Pathological diagnosis was IPMN (n=33) and pancreatic intraepithelial neoplasia type 2 (n=3). Twenty-nine revealed non-invasive neoplasia and invasive form in four patients. MRCP and EUS-FNA have correctly diagnosed and classified (type of IPMN), in 62.5% and 83.3% (p=0.811), the affected segment location in 69% and 92% (p=0.638) and identification of nodules and/or vegetation presence in 45% and 90% (p=0.5). Regarding to histopathological diagnosis by EUS-FNA the sensitivity was 83.3%; specificity was 100%; positive predictive value was 100%; negative predictive value was 33.3% and accuracy was 91.7%. Conclusions:There was no significant difference in the diagnosis of IPMN. However, EUS-FNA showed better absolute results than MRCP to identify nodule and/or vegetation.

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Gastric Perforation Associated With Acute Pancreatitis: Case Report

Cited by 4 publications

References 10 publications

Pancreatite: uma revisão literária do disponível acerca de sua incidência, etiologia, manifestação clínica, diagnóstico, tratamento da patologia ou suas formas de apresentação

Pancreatite: uma revisão literária do disponível acerca de sua incidência, etiologia, manifestação clínica, diagnóstico, tratamento da patologia ou suas formas de apresentação

A Rare Case of Perforated Gastric Remnant after Roux-enY Gastric Bypass

Magnetic Resonance Cholangiopancreatography (Mrcp) Versus Endosonography-Guided Fine Needle Aspiration (Eus-Fna) for Diagnosis and Follow-Up of Pancreatic Intraductal Papillary Mucinous Neoplasms

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