Pancreatic pseudocysts of the duodenum

Bellon, E M; Cr, George; Schreiber, Harold R.; Jb, Marshall

doi:10.2214/ajr.133.5.827

Cited by 16 publications

(16 citation statements)

References 7 publications

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“…However, duodenal intramural pseudocysts are exceedingly rare; we found only 10 cases reported in four English language journal articles [2][3][4][5]. Seven of these patients had underlying acute pancreatitis, whereas the other three had symptoms atypical of acute pancreatitis but no evidence of pancreatic cancer.…”

Section: Discussionmentioning

confidence: 98%

“…Pancreatic pseudocysts, a well-recognized complication of acute pancreatitis and trauma, are usually found around the pancreas, but occur in a variety of locations such as the alimentary tract [2][3][4][5][7][8][9][10], liver [11], and mediastinum [12]. However, duodenal intramural pseudocysts are exceedingly rare; we found only 10 cases reported in four English language journal articles [2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

“…However, an intramural pseudocyst of the duodenum is rare, with very few cases documented [2][3][4][5]. We report what to our knowledge is the documented case of an intramural pseudocyst of the duodenum caused by pancreatic head cancer.…”

Section: Introductionmentioning

confidence: 92%

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Intramural pseudocyst of the duodenum caused by pancreatic head cancer: report of a case

et al. 2012

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An intramural pseudocyst in the alimentary tract develops as a rare complication of acute pancreatitis or trauma. A 60-year-old woman with pancreatic head cancer underwent preoperative radiological examinations, which revealed a 45-mm cystic mass around the second portion of the duodenum. Endoscopic ultrasonography confirmed a cystic lesion in the submucosal layer of the duodenum and fine needle aspiration cytology of the cystic contents suggested adenocarcinoma. The cystic fluid was amylase-rich, at 17040 U/l. We performed pancreaticoduodenectomy for the pancreatic head cancer. Pancreatography of the resected specimen showed a communication between the main pancreatic duct and the cystic lesion. The cut surface of the resected specimen revealed a cystic lesion, which surrounded the duodenum. Pathologically, the cystic lesion was diagnosed as a pseudocyst, located between the dissociated smooth muscle layers of the duodenum.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Intramural pseudocyst of the duodenum caused by pancreatic head cancer: report of a case

et al. 2012

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“…The duodenum is a common target for spontaneous decompression of pancreatic pseudocysts as it is in intimate contact with the tissue-disruptive secretions from pseudocysts at the pancreatic head. Bellon et al note that the posterior aspect of D2 was the most frequent site of involvement [35]. None of the cases involved bleeding but close to 75% had duodenal obstruction in their small series.…”

Section: Literature Reviewmentioning

confidence: 89%

Non-operative Management of Necrotic Pancreatic Collection and Bleeding Pseudoaneurysm Communicating with Bowel Lumen at Multiple Sites: a Case Report and Review of the Literature

Razik

May

Saibil

2016

JGLD

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Pancreatic pseudocysts and foci of walled-off necrosis (WON) are well-known complications of acute pancreatitis. We present a case of severe gallstone pancreatitis complicated by WON, fistulization to the bowel and gastrointestinal bleeding. Bleeding was localized to a pseudoaneurysm of the gastroduodenal artery within the WON using imaging and endoscopy. Angiography and image-guided therapy were then used to control bleeding with coil-embolization. To our knowledge, this is the first report of non-operative management of a patient with severe pancreatitis complicated by WON and a bleeding pseudoaneurysm with multiple communications to the hollow viscera. Therapeutic options are discussed and a thorough literature review is included. Abbreviations: EGD: esophagogastroduodenoscopy; ERCP: endoscopic retrograde cholangiopancreatography; GDA: gastroduodenal artery; GI: gastrointestinal; IEP: interstitial edematous pancreatitis; IPDA: inferior pancreaticoduodenal artery; WON: walled-off necrosis.

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“…The exact mechanism of the formation of the pseudocysts in the GIT wall are not known. The possible mechanisms are suggested for their formation includes rupture of a pancreatic pseudocyst into the GIT wall, presence of a fistula between the pancreas and the alimentary tract and inflammation of heterotopic pancreatic tissue within the GIT wall 345678910111213. Due to their rarity there are no guidelines on their management and most of the described cases in the literature have been either treated surgically or have spontaneously decompressed by rupturing into the GIT lumen 345678910111213…”

Section: Introductionmentioning

confidence: 99%

Intramural pseudocysts of the upper gastrointestinal tract

et al. 2013

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Background:Intramural pseudocysts or pseudocysts occurring in the gastrointestinal tract (GIT) wall are rare and there is a paucity of data on their clinical features and management.Patients and Methods:We retrospectively evaluated patients with intramural pseudocysts seen at our institution over the past 6 years. Intramural location was confirmed either on surgery or endoscopic ultrasound (EUS). Depending upon the symptoms, their control with the conservative medical therapy and procedural consent, the patients underwent EUS guided single time aspiration of the pseudocyst or transmural drainage or transpapillary drainage or surgery.Results:A total of 9 patients with intra mural pseudocysts (male: n = 8; mean age ± SD: 39.3 ± 8.0 years; age range: 24-54 years; five patients having chronic and four patients having acute pancreatitis) were studied. The pseudocysts were located in the wall of the second part of the duodenum in five patients, in the gastric wall in three patients and in the lower esophageal wall in one patient. The size of the pseudocysts ranged from 8 mm to 8 cm and 3/9 (33%) patients had associated extra mural pancreatic pseudocysts. All patients had abdominal pain on presentation. Along with pain the patients with duodenal intramural pseduocysts also had symptoms suggestive of gastric outlet obstruction (3) or jaundice (1). The patient with esophageal intramural pseudocyst had dysphagia along with abdominal pain. Majority of these patients could be successfully treated endoscopically with no significant complications.Conclusions:Intramural pseudocysts of the upper GIT are very rare and EUS is a useful investigational modality for diagnosing and treating them.

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Pancreatic pseudocysts of the duodenum

Cited by 16 publications

References 7 publications

Intramural pseudocyst of the duodenum caused by pancreatic head cancer: report of a case

Intramural pseudocyst of the duodenum caused by pancreatic head cancer: report of a case

Non-operative Management of Necrotic Pancreatic Collection and Bleeding Pseudoaneurysm Communicating with Bowel Lumen at Multiple Sites: a Case Report and Review of the Literature

Intramural pseudocysts of the upper gastrointestinal tract

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