Pancreatic Pseudocyst Resolution After Parathyroidectomy for Hyperparathyroidism

Abstract

Hyperparathyroidism is a rare cause of pancreatic inflammatory disease. Appropriate treatment of coexistent hyperparathyroidism and pancreatitis, especially when complicated by pseudocyst formation, is unsettled. We describe two patients with primary hyperparathyroidism who developed pancreatitis associated with multiple pseudocysts. The largest cyst in each patient was 9 and 5 cm, respectively. After correction of hyperparathyroidism and normalization of serum calcium levels by removal of a parathyroid adenoma, the pseudocysts resolved in both patients, as documented with computed tomography. We conclude that uncomplicated pancreatic pseudocysts in patients with primary hyperparathyroidism can be treated expectantly. Surgical correction of hyperparathyroidism and normalization of serum calcium levels should precede pancreatic intervention when possible, since pseudocyst resolution is likely and the risks of postoperative hypercalcemia are avoided.

Hemosuccus pancreaticus following Parathyroidectomy for Primary parathyroid adenoma

“…In conclusions, our case was first described as Hemosuccus pancreaticus can occur following for Primary parathyroid adenoma after Parathyroidectomy, although Chronic pancreatitis and sequent complations due to hyperparathyroidism ofen relieves some clinical manifestations on majority of patients underwent parathyroidectomy (4,5,9). Early diagnosis and correct management is essential in preventing the bleeding.The diagnosis of hemosuccus pancreaticus requires a high level of expertise.…”

“…While, the effect of parathyroidectomy on pancreatic pseudocysts complicated with PHPT is less clear due to paucity of information regarding the clinical characteristics of pancreatic disease in hyperparathyroidism (5,8) .…”

“…Some studies suggest that correction of hyperparathyroidism and normalized serum calcium levels may ameliorate the associated pancreatitis (4,5), however, surgical resection of primary parathyroid adenoma has been questioned. To this point, the surgery may not reverse the pancreatic pathology and long-term therapy for exocrine and endocrine pancreatic insufficiency may be required (6) P .…”

Mediastinal Pancreatic Pseudocysts that were Resolved following Parathyroidectomy for Primary Hyperparathyroidism

“…Therefore, in patients with pancreatitis complicated with primary hyperparathyroidism, surgical correction of hyperparathyroidism is needed, however, the treatment of pancreatic pseudocysts complicated with primary hyperparathyroidism is controversial. There has been only one report; the pancreatic pseudocysts were resolved in two patients after correction of hyperparathyroidism by removal of a parathyroid adenoma (8).…”

Severe Acute Pancreatitis as a First Symptom of Primary Hyperparathyroidism

“…The frequency of pancreatitis HPT is thought to be less than 1%. 6 The serum calcium level is believed to be directly associated with the severity of an acute pancreatitis attack. Some studies suggest that parathyroidectomy may ameliorate the course of pancreatitis, 4,5 but others have not confirmed this observation.…”