Hemorrhagic pancreatic pseudocyst: A rare complication

Kudaravalli, Pujitha; Garg, Nikita; Pendela, Venkata Satish; Gambhir, Harvir Singh

doi:10.1016/j.ajem.2020.03.020

Cited by 8 publications

(8 citation statements)

References 4 publications

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“…Lesion rupture is one potential complication of cystic pancreatic disease. Pujitha Kudaravalli et al pointed out that the mortality of pancreatic hemorrhagic pseudocysts is around 40%, and approximately 13% of pancreatic pseudocysts may be associated with hemorrhage ( 3 ). The mechanism of rupture may be continuous pancreatic necrosis and exudation, resulting in a continuous increase in pathological contents, excessive internal pressure, overload, and thus rupture.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Rupture and Hemorrhage of WON: A Case Report

Yan

Yu²,

Yan³

et al. 2022

Front. Surg.

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BackgroundPancreatic pseudocysts are characterized by the leakage of pancreatic juice caused by various reasons, which leads to pancreatic juice accumulates around the pancreas, and stimulates the greater omentum and other tissues to form an area of fibrotic loculated effusion with an integrated capsule. Approximately, one-third of patients experienced recurrent pancreatic juice leakage, compression symptoms, infection, and bleeding, which requires surgical intervention, but spontaneous rupture cases are extremely rare.Case presentationWe here present the case of 40-year-old male who presented with abdominal pain and vomiting for two days and 10 h, respectively. He had a history of chronic pancreatitis and pseudocysts. The symptoms of abdominal pain worsened in the second day. Laboratory tests showed a progressive decrease in hemoglobin. Then, emergency pancreatoduodenectomy was performed. Intraoperative exploration found a small blood clot in the abdominal cavity and a hematoma that had formed in the intestinal cavity and retroperitoneum.ConclusionThis case showed that pseudocysts of the pancreas can rupture under certain circumstances, leading to intraperitoneal bleeding and hematoma formation, which can endanger the life of the patient. And surgical treatment can be the first choice for hemorrhagic pseudocysts.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Rupture and Hemorrhage of WON: A Case Report

Yan

Yu²,

Yan³

et al. 2022

Front. Surg.

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“…Hemorrhagic shock caused by bleeding from the cyst wall is found to be obvious by autopsy in this case, and it is often said that bleeding from the cyst wall occurs in 6–17% of patients with chronic pancreatitis, with case fatality rate being 40% without early intervention. Pseudopancreatic cysts and the gastrointestinal tract can also form fistulas and cause upper or lower gastrointestinal bleeding [ 10 , 11 ]. Araki et al.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding treatment options, TAE and surgery are assumed as described above, but it is often said that the mortality rate is 20–29% when surgery is performed in hemodynamically unstable patients with cyst rupture included in this study. Thus, TAE, but not surgery, is considered to be first-line treatment [ 10 ]. Actually, we considered TAE and surgery for the patient in this study, but we had difficulty determining the right timing of surgery and TAE.…”

Section: Discussionmentioning

confidence: 99%

Systemic lupus erythematous presenting with hemorrhagic shock caused by gastric penetration of pancreatic pseudocyst: a case report

Itagaki¹,

Katuhiko²

2021

J Med Case Reports

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Background Systemic lupus erythematous that causes various organ damage is rarely associated with pancreatic lesion. To the best of our knowledge, no cases presenting with hemorrhage shock caused by gastric penetration of pancreatic pseudocyst due to lupus pancreatitis have been reported. Herein, we report a case of hemorrhage shock caused by gastric penetration of pancreatic pseudocyst due to lupus pancreatitis. Case presentation A 53-year-old Japanese man with a history of systemic lupus erythematous, pancreatic pseudocyst, and chronic pancreatitis complained of epigastric pain and had hematemesis. He visited our emergency room and was admitted in our hospital. Upper endoscopy showed that hemostasis was obtained; however, computed tomography scan was performed since he was suspected to have gastric penetration into hollow viscera. The computed tomography revealed accumulation of fluid around the pancreas and gastric penetration of pancreatic cyst. Blood test showed increased serum amylase level. These results suggest that the exacerbation of chronic pancreatitis causes the penetration. Surgery was considered; however, we took a wait-and-see approach since hemostasis was obtained. After that, he was in stable condition, although he suffered from fever and accumulation of left pleural effusion was observed by computed tomography. However, he had massive hematemesis and melena 9 days after hospitalization and died in spite of several treatments including blood transfusion. Autopsy revealed that he actually had pleural thickening, which is not caused by accumulation of left pleural effusion but by severe pleural inflammation. We therefore performed additional blood and urinary tests on the same day. The test results showed that he had a high titer of anti-double-stranded deoxyribonucleic acid (DNA) antibody, hypocomplementemia, and erythrocyturia, indicating that he had systemic lupus erythematous with high disease activity considering his fever and pleural inflammation. Conclusions Patients who have systemic lupus erythematous with high disease activity have the potential to develop fatal complications due to pancreatitis, so appropriate treatments are required for such patients.

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“…Псевдокисты составляют две трети всех кистозных образований поджелудочной железы и встречаются чаще, чем кистозные неоплазии, которые составляют 10-15% всех кистозных поражений поджелудочной железы [4]. Заболеваемость псевдокистами состав-ляет 1,6-4,5 на 100 000 взрослого населения в год [2,15], а распространенность колеблется от 10-20% при остром панкреатите до 20-40% при хроническом панкреатите [16]. В исследованиях у пациентов с хроническим панкреатитом, осложненным псевдокистами, среди причин в 70-78% был алкогольный хронический панкреатит, 6-16% -идиопатический хронический панкреатит и 6-8% -хронический билиарный панкреатит [17].…”

Section: эпидемиологияunclassified

“…Большинство псевдокист поджелудочной железы возникают после перенесенного острого и хронического панкреатита [15,19]. Клиническая картина пациентов с псевдокистой поджелудочной железы варьируется от бессимптомной до серьезной абдоминальной патологии из-за осложнений [20].…”

Section: диагностикаunclassified

Current treatment of pancreatic pseudocysts: a systematic review

Durleshter¹,

Генрих

Макаренко³

et al. 2021

Kuban. nauсh. med. vestnik

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Background. Pancreatic pseudocysts stand among current challenges in modern medicine. Their treatment uses variant instrumental techniques and implies a multispecialty approach. Trials in surgery and gastroenterology have aimed to identify an optimal strategy to tackle pancreatic pseudocysts for reducing complications and the recurrence rate, suggesting ultrasound-guided percutaneous, laparoscopic and flexible endoscopic drainage as promising treatment choices.Objectives. A summarising review of diagnostic and therapeutic methods for pancreatic pseudocyst treatment and comparison of ultrasound-guided percutaneous vs. surgical and endoscopic drainage techniques.Methods. The review examines the classification, epidemiology and methods for diagnosis and treatment of pancreatic pseudocysts. Only comparative full-text studies published within 2014–2021, as well as selected impactive publications within 2002–2013, have been included. The eLibrary, Elsevier and PubMed resources were queried for the article or journal title fields against the keywords (separate or combined) “pancreatic pseudocyst” [псевдокиста поджелудочной железы], “pseudocyst drainage” [дренирование псевдокисты], “surgical drainage” [хирургическое дренирование], “endoscopic drainage” [эндоскопическое дренирование], cystogastrostomy [цистогастростомия], gastrojejunostomy [гастроеюностомия], “duodenal-cystic anastomosis” [цистодуоденоанастомоз], “transpapillary drainage” [транспапиллярное дренирование], “transmural drainage and esophagogastroduodenoscopy” [трансмуральное дренирование и эзофагогастродуоденоскопия]. Records have been selected for topic-related scientific value.Results. The review systematically surveys 68 scientific papers in the focus area and summarises the most common surgical methods for pancreatic pseudocyst treatment. Based on the main principle, the methods are classified into three categories, ultrasound-guided percutaneous drainage, surgical drainage and flexible endoscopic drainage. The major classifications and treatment techniques are highlighted for their advantages and disadvantages.Conclusion. There exist no generally adopted strategy for pancreatic pseudocyst treatment in current clinical practice and no evidence on a particular method application in a large patient cohort. The publication survey identifies the techniques of percutaneous, surgical and endoscopic drainage with ultrasound control as highly effective overall among other surgical treatments.

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Hemorrhagic pancreatic pseudocyst: A rare complication

Cited by 8 publications

References 4 publications

Spontaneous Rupture and Hemorrhage of WON: A Case Report

Spontaneous Rupture and Hemorrhage of WON: A Case Report

Systemic lupus erythematous presenting with hemorrhagic shock caused by gastric penetration of pancreatic pseudocyst: a case report

Current treatment of pancreatic pseudocysts: a systematic review

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